Bahamondes Luis, Mansour Diana, Fiala Christian, Kaunitz Andrew M, Gemzell-Danielsson Kristina
Professor of Gynaecology, Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.
J Fam Plann Reprod Health Care. 2014 Jan;40(1):54-60. doi: 10.1136/jfprhc-2013-100636. Epub 2013 Sep 27.
Few studies in the scientific literature provide clear direction on the prevention or management of pain associated with intrauterine contraceptive (IUC) placement. Those that have been published have studied small numbers of women and fail to provide definitive conclusions. There are also no guidelines available detailing recognised standard approaches to this problem. The consensus recommendations in this review focus primarily on non-pharmacological and often non-evidence-based interventions. This review includes general considerations, practical recommendations for both routine and more difficult cases and guidance on the optimal choice of instruments. General considerations, including pre-insertion counselling, the setting for the procedure, the confidence and technique of the provider and the interplay between the provider and assistant, can influence women's level of anxiety and, in turn, influence their perception of pain and their overall experience. Further studies are required to refine the optimal strategy for managing pain associated with IUC insertion.
科学文献中很少有研究能为宫内节育器（IUC）放置相关疼痛的预防或处理提供明确指导。已发表的相关研究样本量小，未能得出确定性结论。目前也没有详细阐述该问题公认标准方法的指南。本综述中的共识性建议主要集中在非药物干预措施上，且这些措施往往缺乏循证依据。本综述涵盖了一般注意事项、针对常规及更复杂情况的实用建议以及器械最佳选择的指导。一般注意事项，包括放置前咨询、操作环境、医护人员的信心和技术以及医护人员与助手之间的协作，会影响女性的焦虑程度，进而影响她们对疼痛的感知及整体体验。需要进一步研究以完善管理IUC放置相关疼痛的最佳策略。
