Elsevier

Journal of Minimally Invasive Gynecology

Volume 19, Issue 5, September–October 2012, Pages 581-584
Journal of Minimally Invasive Gynecology

Original Article
Comparison of the Analgesic Effects of Oral Tramadol and Naproxen Sodium on Pain Relief During IUD Insertion

https://doi.org/10.1016/j.jmig.2012.04.004Get rights and content

Abstract

Objective

To compare the analgesic efficacy of oral tramadol and naproxen sodium on pain during insertion of an intrauterine device (IUD).

Design

Randomized, double-blinded, clinical trial (Canadian Task Force classification I).

Setting

University-affiliated hospital. Single-center.

Patients

One hundred three patients scheduled for insertion of an IUD.

Interventions

Patients were randomly assigned to receive oral tramadol 50 mg capsules (n = 35) or naproxen sodium 550 mg tablets (n = 34) or placebo (n = 34) 1 hour before insertion of the IUD. After insertion of the IUD, pain intensity was evaluated using a visual analog scale (VAS, 0–10). Adverse effects, patient satisfaction with the medication, and preference for using it during future insertions were also recorded.

Measurements and Main Results

The VAS scores were significantly different during IUD insertion among the 3 groups (p = .001). Pain scores in the tramadol group were significantly lower than in the naproxen group (p = .003), and the scores in the naproxen group was significantly lower than in the control group (p = .001). Patient satisfaction with the medication and preference for its future use were significantly lower in the control group than in the other 2 groups (p = .001).

Conclusion

Prophylactic analgesia using 50 mg tramadol and 550 mg naproxen, delivered orally, can be used to relieve pain during IUD insertion. However, tramadol capsules were found to be more effective than naproxen tablets.

Section snippets

Materials and Methods

After approval from the local ethics and research committees, written informed consent was obtained from 103 healthy (physical status ASA I) multiparous women of childbearing age (18–49 years) who had been scheduled for IUD insertion. The study was randomized, controlled, and double blinded. Exclusion criteria were known allergy or hypersensitivity to NSAIDs or tramadol hydrochloride; current use of any narcotic or NSAID; history of epilepsy, peptic ulcer disease, bleeding disorder, asthma, or

Results

One hundred three patients were included in the study, 34 in group N, 34 in group C, and 35 in group T. The distribution of groups did not differ significantly from normality (Lilliefors test, p >.05). No significant between-group differences were observed in patient characteristics (Table 1). The IUDs were inserted in a standard manner by the same physician. The VAS scores were significantly different between the 3 groups (F (2, 100) = 101; p = .001) (Fig. 1). Variances were homogeneous

Discussion

In this randomized double-blinded study, orally administered tramadol and naproxen sodium were compared with placebo. Tramadol, 50 mg, demonstrated significantly superior analgesic effects over naproxen sodium, 550 mg, and placebo during the IUD insertion procedure. The mean pain score in the naproxen group was significantly lower than in the placebo group. Thus, we concluded that tramadol efficacy was better for pain control.

NSAIDs reduce pain and inflammation by blocking cyclooxygenase enzyme

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The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.

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