About the Study: Intrauterine instillation of 10 mL of mepivacaine (20 mg/mL) significantly reduced pain and improved tolerability during IUD placement compared with instillation of placebo saline.
In this multicenter randomized clinical trial of 370 nulliparous individuals undergoing placement of smaller-diameter IUDs, intrauterine instillation of mepivacaine reduced pain during IUD placement compared with placebo saline and improved tolerability. The findings support mepivacaine instillation as a simple approach that could improve the IUD placement experience.
Corresponding Author: Karin Elgemark, MD, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, S-171 77, Stockholm, Sweden ( karin.elgemark@ki.se ).
10.1001/jama.2026.14217
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