Intrauterine Mepivacaine Instillation vs Placebo for Pain During Intrauterine Device (IUD) Placement: A Randomized Clinical Trial
Authors' conclusion
Intrauterine instillation of 10 mL of mepivacaine (20 mg/mL) significantly reduced pain and improved tolerability during IUD placement compared with instillation of placebo saline.
Study context
- Population
- Nulliparous individuals aged 18 to 31 years opting for IUDs with smaller-diameter placement tubes, 11 outpatient clinics in Swedenrandomized
- Participants
- 370 individuals
- Comparison
- Mepivacaine vs Placebo
- Mepivacainen = 185
- Placebon = 185reference
- Primary endpoint
- Clinician-adjusted difference in pain scores during IUD placement (100-mm VAS)
Methodological detailsmulticentre, double-blind, placebo-controlled
- Multicentre
- Double-blind
- Placebo-controlled
Primary result
Pain during IUD placement (100-mm VAS)
Mean difference
14.8 mm
95% CI 10.0–19.6
P < 0.001
By group
Mepivacaine vs Placebo
mean difference 14.8 mm (95% CI 10.0–19.6); P < 0.001
As reported in the abstract
Further findings
| Outcome | Mepivacaine | Placebo | RR (95% CI) | |
|---|---|---|---|---|
| Tolerable painNNT 15 (95% CI, 9-43) | 98.3% | 91.4% | 1.08 (1.02–1.13) | |
| 0.512Relative risk (log scale) |
- Tolerable pain: 172 of 175 vs 159 of 174
Original publication
Intrauterine Mepivacaine Instillation vs Placebo for Pain During IUD Placement: A Randomized Clinical Trial. JAMA. Published 17 September 2026. doi:10.
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