Pain Management Interventions and Success of Intrauterine Device Insertions at a Single Institution [ID 595]

INTRODUCTION: Standard of care remains variable for intrauterine device (IUD) placement pain control despite recent guidelines. Our study investigates whether pain management interventions prior to or during IUD insertion are associated with successful IUD insertion. Secondary aims include the specific pain medications, patient characteristics, and physician characteristics associated with successful IUD insertion. METHODS: A retrospective chart review was conducted for IUD insertions performed by Vanderbilt University Medical Center ob-gyn providers at one clinic location from January 1, 2023, to December 31, 2023. Multivariable logistic regression was performed to determine independent predictors of successful IUD insertion. RESULTS: Medication use was associated with a higher successful IUD insertion rate (96.7%) compared to those without medication (93.9%) (odds ratio [OR] 2.241, P =.109). Mechanical dilation and history of prior failed IUD insertion were significant negative predictors of IUD insertion (OR 0.14, 95% CI, 0.06–0.32; OR 0.20, 95% CI, 0.06–0.70). 23.9% of procedures used any pain medication for IUD insertions, with NSAIDS being the most common. Among providers, complex family planning physicians used medication most often (47.9% of their visits), with a preference for local anesthetics. CONCLUSIONS/IMPLICATIONS: A positive association was determined between pain management and successful IUD insertion, although not statistically significant. Of note, this study highlighted the variability in usage and type of medication in IUD insertion. These results call for further research into optimal pain management for IUD insertions to improve the quality of care and patient experience.