• Colleen P McNicholas, Tessa Madden, Qiuhong Zhao, Gina Secura, Jenifer E Allsworth, and Jeffrey F Peipert.
• Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA. mcnicholasc@wudosis.wustl.edu
• Am. J. Obstet. Gynecol. 2012 Nov 1;207(5):384.e1-6.

ObjectiveAnticipated pain with intrauterine device (IUD) insertion may be a barrier to widespread use. Our objective was to evaluate the efficacy of intracervical 2% lidocaine gel for pain relief with IUD insertion.Study DesignWe performed a double-blind, randomized controlled trial of women undergoing IUD insertion. Participants were randomly assigned to 2% lidocaine or placebo gel. Study gel (3 mL) was placed 3 minutes prior to IUD insertion. Pain scores were measured at various time points using a 10-point visual analog scale.ResultsOf the 200 participants randomized, 199 completed the study. Pain scores among lidocaine and placebo arms were similar at tenaculum placement (lidocaine and placebo: median, 4; range, 0-10; P = .15) and with insertion (lidocaine: median, 5; range, 1-10; placebo: median, 6; range, 0-10; P = .16). These results did not differ by parity.ConclusionTopical or intracervical 2% lidocaine gel prior to IUD insertion does not decrease pain scores.Copyright © 2012 Mosby, Inc. All rights reserved.

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