الفهرس 
Introduction
Aim of the studyOnly 14 pages are availabe for public view
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Abstract
Our study was to compare the analgesic effect of topical application of glyceryltrinitrate (GTN) and lidocaine cream during IUD insertionIn this study women who have chosen the IUD as their contraceptivewere divided into three groups randomly in randomized controlled trial assigned as: group (1): received glyceryltrinitrate cream group (2): received lidocaine cream group (3): received placebo cream The level of pain at six different time points on a 10 point visual analog scale (VAS) and the patient’s satisfaction with the procedure has been compared between the three groups. Study outcome measures : Primary Outcome measuremean pain score during IUD insertion using visual analoge scale ( VAS score ). Secondary Outcomes measure : Insertion difficulty as rated by the clinician Patient satisfaction after the procedure Insertion complications Side effects of both drugs The aim of our study is to compare the analgesic effect of topical application of glyceryltrinitrate (GTN) and lidocaine cream during IUD insertion We found that there were statistical significant difference in analgesic effect between lidocaine and GTN group during IUD insertionin GTN group and no significant difference between lidocaine and GTN group during Cusco insertion ,vollselum application, uterinesounding, removal of instruments and 5 min post procedure. We found a statistical significant difference between GTN group and Placebo group at all steps of IUD insertion except at cusco speculum insertion. We found a statistical significant difference between Lidocaine group and Placebo group at two steps of IUD insertion (at volsellum application & at uterine sounding) while no statistical significant difference during Cusco speculum insertion, IUD insertion, removal of instruments, 5 min post procedure. We found no statistical significant difference between the study groups regarding to age , parity , residency , previous vaginal delivery , previous CS, previous abortion , Time of insertion,previous IUD , education , dysmenorhea , Lactation and position of the uterus. We found that there is no statistcal significant difference between all groups as regard the ease of insertion and the duration of insertion or the satifactionscore after the procedure. No cases of failure or perforation. No side effects reported from the study medication. No reported local or systemic side effects in women who received either lidocaine cream or GTN cream within 24 h. Logistic regression analysis to evaluate predictors of pain during IUD insertion show the individual characteristics that could affect the perception of pain during IUD insertion as Age, parity, Vaginal delivery, Previous CS, Previous IUD insertion, History of dysmenorrhea and Position of the uterus were not predictors of pain during insertion.In our study, there wereno reported local or systemic side effects in women whoreceived either lidocaine cream or GTN cream within 24 h.