From the Research
Tramadol can be used for premedication to manage pain during IUD insertion, though it's not considered a first-line option. When used for this purpose, tramadol is typically administered at a dose of 50 mg orally 1 hour before the procedure, as shown in a study comparing tramadol and naproxen for pain relief during IUD insertion 1. However, NSAIDs like ibuprofen or naproxen are generally recommended first due to their better safety profile and comparable efficacy. According to a 2015 Cochrane review, some lidocaine formulations, tramadol, and naproxen had some effect on reducing IUC insertion-related pain in specific groups 2. A 2016 randomized controlled trial found that oral naproxen sodium does not reduce pain with IUD insertion but does reduce pain after insertion 3.
- Key points to consider:
- Tramadol works by binding to opioid receptors and inhibiting serotonin and norepinephrine reuptake, providing moderate pain relief.
- Tramadol may cause side effects including dizziness, nausea, constipation, and drowsiness, so patients should arrange transportation home after the procedure.
- It also carries a risk of dependence and should be used cautiously in patients with a history of substance abuse or those taking other CNS depressants.
- For most patients undergoing IUD insertion, starting with NSAIDs and considering local anesthetic techniques may provide adequate pain management with fewer risks than tramadol.
- A 2017 study found that none of the study drugs, including lidocaine, misoprostol, and naproxen, seemed effective prior to IUD insertion, highlighting the need for future research into new strategies to decrease pain during IUD placement 4.