Methoxyflurane for intrauterine device insertion in conscious patients, an open, single arm pilot study testing feasibility and medication acceptability

While intrauterine devices (IUDs) are amongst the most reliable contraceptives, inserting them can be painful. We try to reduce this pain, but there is no strong evidence to support any of the medicines we currently use. Methoxyflurane is an inhaled pain relief which is commonly used for other surgical procedures when awake, but it has not yet been tested for its suitability for patients having gynaecological procedures. We performed a pilot study (a preliminary investigation) to ask 30 patients using methoxyflurane during IUD insertion about their experience. Our results are: 1. 97% of patients using methoxyflurane for IUD insertion felt that the using the drug was 'completely acceptable'. The remaining 3% said it was 'mostly acceptable. The same 97% said 'definitely yes' to whether they would want it in the same situation again. The remaining 3% said they were 'not sure'. 2. The average pain score of these patients when describing the 'worst pain' during the IUD insertion was 47/100. 3. The most common side effect was dizziness/light headedness and it was experienced by 27% of patients (9 people). 8/9 graded this symptom as mild, 1/9 called it moderate. Other side effects included euphoria in 18% (feeling high) or an irritated throat in 6%. In conclusion, methoxyflurane was highly acceptable for our 30 patients having IUDs inserted. It is now suitable for us to perform more studies to measure the degree of benefit.