HealthDay News — For patients undergoing intrauterine device (IUD) placement, ketorolac does not reduce pain with placement, but is associated with pain reduction at five and 15 minutes after placement, according to a study published online in Obstetrics & Gynecology.

Lynn L. Ngo, MD, from the University of California in San Francisco, and colleagues conducted a randomized trial to compare intramuscular ketorolac with placebo saline injection for pain control with IUD placement. 

Participants were randomized to receive 30 mg ketorolac (33 women) or placebo saline injection (34 women) 30 minutes before IUD placement.

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The researchers observed no differences in the median pain scores for IUD placement in the placebo versus ketorolac groups (5.2 versus 3.6 cm on a visual analog scale; P = 0.99). A decrease in median pain score was seen with ketorolac versus placebo at five minutes (0.3 versus 2.2 cm; P ≤ 0.001) and at 15 minutes (0.1 versus 1.6 cm; P ≤ 0.001) after IUD placement; no difference was seen for other time points. 

The injection pain was reported as being as painful as IUD placement by 22% of the placebo group and 18% of the ketorolac group.

“Ketorolac does not reduce pain with IUD placement but does reduce pain at five and 15 minutes after placement,” the authors write.

One author is a Nexplanon trainer.


1. Ngo L, et al. Obstet Gyn. 2015; doi: 10.1097/AOG.0000000000000912