Does the cervical canal passage axis have an effect on pain sensation in IUD application?: a randomized controlled trial

Year 2020, , 330 - 335, 18.06.2020

Buğra Çoşkun , Mahmut Kuntay Kokanalı , Ramazan Erda Pay , Coşkun Şimşir , Mehmet Ferdi Kıncı , Bora Çoşkun , Tolga Ecemis , Kazım Emre Karaşahin

https://doi.org/10.32322/jhsm.738957

Abstract

Aim: To investigate the effect of the axis of the IUD wings in the cannula on the pain felt while passing the cervical canal.
Material and Method: Ninety-one patients who underwent IUD application in the family planning policlinic were enrolled in the study. The patients were randomly divided into two groups according to the IUD application sequence number. Odd numbers were included in the 'Transverse application' (Group I), while even numbers were included in the 'Vertical application' (Group II) group. After the procedure, patients were informed about the visual analog scale (VAS) by another doctor who did not perform the procedure. Patients rated pain intensity during the procedure from 0 (zero, painless) to 10 (ten, highest pain) on VAS.
Results: No statistically significant difference was found between the groups in terms of age, gravida, parity, body mass index, cervical length, previous cesarean history, presence of retroverted uterus. There was no statically significant difference according to VAS scores between the groups, but the mean VAS score was lower in Group II. Also, the presence of severe pain (VAS score>8) was statistically significantly higher in Group I. Transverse application procedure (OR: 1.21, 95% CI: 0.21-6.70, p = 0.042) was found to be a significant independent factor for the presence of severe pain in multiple regression analysis.
Conclusion: In the IUD application procedure, passing the cervical canal while the wings in cannula are in the vertical axis has been associated with less pain felt.

Keywords

Intrauterine device, pain, visual analog scale

RİA uygulamasında servikal kanalı geçiş ekseninin ağrı hissine etkisi var mıdır?: randomize kontrollü bir çalışma

Abstract

Amaç: Rahim içi araç uygulamasında servikal kanal geçerilirken kanül içerisindeki kanatların ekseninin hissedilen ağrıya etkisini araştırmak
Gereç ve Yöntem: Aile planlaması polikliniğinde rahim içi araç uygulaması yapılan 91 hasta çalışmaya dahil edildi. Hastalar rahim içi araç uygulama sıra numarasına göre rastgele iki gruba ayrıldı. Tek sayılar ‘Yatay uygulama’ (Grup I), çift sayılar ise ‘Dikey uygulama’ (Grup II) grubuna dahil edildi. İşlem sonrası hastalar, başka bir doktor tarafından vizüel analog skala hakkında bilgilendirildi ve işlem sırasında hissettikleri ağrı yoğunluğunu vizüel analog skalaya göre 0 (sıfır, ağrısız) ila 10 (on, en yüksek ağrı) arasında derecelendirdi.
Bulgular: Gruplar arasında yaş, gravida, parite, vücut kitle indeksi, servikal uzunluk, sezaryen öyküsü, retrovert uterus varlığı açısından istatistiksel olarak anlamlı bir fark yoktu. Gruplar arasında vizüel analog skala skorlarına göre istatistiksel olarak anlamlı fark yoktu, ancak Grup II’de ortalama vizüel analog skala skoru daha düşüktü. Ayrıca Grup I’deki şiddetli ağrı varlığı (vizüel analog skala skoru>8) istatistiksel anlamlı daha yüksekti. Enine uygulama prosedürü (OR:1,21, %95 CI:0,21-6,70, p=0,042) çoklu regresyon analizinde şiddetli ağrı varlığı için anlamlı bir bağımsız faktör olarak bulunmuştur.
Sonuç: Rahim içi araç uygulama prosedüründe, kanüldeki kanatlar dikey eksendeyken servikal kanalı geçmek daha az ağrı hissi ile ilişkilendirilmiştir.

Keywords

Rahim içi cihaz, ağrı, vizüel analog skala

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