الفهرس 
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Abstract
This case control study was conducted at Department of family
planning at Al Shohadaa Hospital in the period between December
2018 and January 2020.
The population of this study was non-pregnant women who
attended family planning clinic and requested an IUCD insertion aged
18–45 years and delivered before by only elective caesarean section.
The study included 96 women who fulfilled inclusion criteria.
They were subjected to full history taking and physical and local
examination then they were randomized by shuffling technique (ratio
1:1) into 2 groups each of them had 48 women. group A included 48
women received 400 μg misoprostol; 2 tablets vaginally of (Misotac®
200 μg, Sigma Ph., Egypt) three hours before IUCD insertion and
lignocaine spray (Manoviperacaine® 10% mg, EVA PHARMA,
Egypt) three puffs to the cervical surface and one puff to the external
cervical os 3 minutes before IUCD insertion. group B (control group)
included 48 women did not receive any medical intervention.
IUCD was inserted to women in lithotomy position, Patients
were observed for 30 minutes after the procedure. Patients were asked
to rate their pain level on two different levels (immediately after
grasping the cervix with the vulsellum and after sounding the uterus
and insertion of the IUCD). Assessment of pain on those two levels
was made on a modified continuous 10-cm Visual analogue scale
(VAS) to quantify the pain, from 0 cm (no pain) to 10 cm (the worst
pain ever).
This case control study assessed the efficacy and safety of
vaginal misoprostol and lignocaine spray before IUCD insertion.
Summary
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Statistical analysis of the current study showed that combined
use of vaginal misoprostol and lignocaine spray had led to reduction
in pain scores during sounding the uterus and during IUCD insertion,
however, there were no significant statistical difference between two
groups regarding the pain during grasping the cervix with vulsellum.
Also, the current study had shown that the duration needed for
IUCD insertion was lesser in group A than group B, moreover the
uterine length by sound was significantly shorter in group A than
group B.
Although the pain scores during IUCD insertion were lower in
group A, there was no significant statistical difference between both
groups regarding insertion result (failed, easy or difficult insertion)
and complications (No complication, post insertion bleeding or post
insertion pain).