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Entonox® analgesia for IUD insertions and removals
  1. Liz Clare Vincent, BMBS, DFSRH
  1. Eppy Sewell, RGN, NMP
  1. Clinical Lead, Brookside CASH Clinic, Aylesbury, UK; elizabeth.vincent{at}
  2. Clinical Nurse Specialist, Contraception, Brookside CASH Clinic, Aylesbury, UK; Eppy.Sewell{at}

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We intend to begin offering Entonox® (a medical anaesthetic gas comprising 50% nitrous oxide and 50% oxygen) as an analgesic choice for women attending for intrauterine device (IUD) fittings or difficult removals in our community contraception clinics.

Entonox is already used for short-term pain relief in the community by district nurses and midwives, and in the hospital emergency and obstetric departments. The dentist working within our community clinic uses it nasally.

There are no contraindications to use. Entonox is already licensed for “short-term relief for procedures inevitably involving pain”, so according to the manufacturer (BOC Healthcare, Manchester, UK) there is no reason why we could not use it. Because Entonox is rapidly metabolised by the human body, the client would still be able to walk or drive home after the procedure.

We would welcome hearing of others’ experience of using Entonox for IUD insertions or removals as there is very little evidence in the scientific literature to guide us. Anything that improves the client's experience of an IUD fitting and the subsequent ‘word of mouth’ messages that she conveys to her peers would be very helpful.

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  • Competing interests None.

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