YANNEY, HENRY EKOW2025-01-282025-01-282021-09-30https://repository.gcps.edu.gh/handle/123456789/38Background In Ghana, only 0.8% of married and 0.4% of unmarried women are on IUD. The perception of pain at IUD insertion is one of the main barriers of its uptake. Several pharmacological and non-pharmacological interventions have been studied. Despite these attempts, there is currently no consensus on the best form of pain management at IUD insertion. The aim of this study was therefore to compare the effectiveness of counselling only (standard of care), 10% lidocaine spray of the cervix and 100mg suppository diclofenac sodium in reducing pain at IUD insertion. Methodology A prospective study involving women of reproductive age who presented at the Family Planning Unit, Korle Bu Teaching Hospital and had accepted IUD method of contraception was conducted. Clients who met the inclusion criteria were randomized into 3 arms; suppository diclofenac, lidocaine spray and counselling only arms in a ratio of 1:1:1. A calculated sample size of 99 participants, 33 in each arm was used. All participants had a baseline counselling on the procedure and then those on diclofenac arm were given 100mg diclofenac sodium suppository 30 minutes whilst the 10% lidocaine spray arm were given 4 pumps on the cervix before the insertion. Using a 10cm- Visual Analog Scale (VAS), the pain experienced at various stages of IUD insertion, the overall pain experienced after IUD insertion, 5 minutes and 4 hours post procedure were assessed. Mean pain scores were compared using a one way ANOVA and a Post-Hoc test used to compare which two groups were significantly different from each other. Categorical variables between groups were compared using a chi-square test. The statistical significance was set at p < 0.05 and confidence interval at 95%. Results Ninety nine participants were recruited for the study. The average age of the participants was 33.6+ 6.2 years whilst the average BMI was 29.5+ 5.7kg/m2. There were 11/99 (11.11%) of respondents who were single, 3/99 (3.03%) who did not have formal education, 39/99 (39.39%) of them who had tertiary education; and 34/99 (34.34%) who were professionals. Traders and artisans represented 31/99 (31.31%) each and majority 93/99 (93.94%) were Christians. Suppository diclofenac was superior to counselling only at pain control during speculum insertion, tenaculum insertion, uterine sound insertion, IUD placement, immediately after procedure and 5 minutes after procedure. Lidocaine spray of the cervix on the other hand, was superior to counselling only throughout the procedure and up to 4 hours post procedure. Again, Lidocaine spray of the cervix was found to be superior to suppository diclofenac at pain control 5 minutes after procedure (mean pain score 0.6 versus 1.5) and 4 hours after procedure (0.7 versus 0.9) Conclusion Lidocaine spray (10%) of cervix is more effective compared to 100mg Diclofenac Sodium in reducing pain at IUD insertion. The use of 10% lidocaine spray of cervix at insertion of IUD will therefore greatly enhance clients’ satisfaction at IUD insertion and in the long run help to increase the uptake of the IUD, a highly effective long acting reversible contraceptive.enCOMPARISON OF EFFECTIVENESS OF COUNSELLING ONLYSUPPOSITORY DICLOFENAC AND LIDOCAINE SPRAY AT INTRAUTERINE DEVICE INSERTION