Comparison of the analgesic effects of oral tramadol and naproxen sodium on pain relief during IUD insertion

J Minim Invasive Gynecol. 2012 Sep-Oct;19(5):581-4. doi: 10.1016/j.jmig.2012.04.004. Epub 2012 Jul 4.


Objective: To compare the analgesic efficacy of oral tramadol and naproxen sodium on pain during insertion of an intrauterine device (IUD).

Design: Randomized, double-blinded, clinical trial (Canadian Task Force classification I).

Setting: University-affiliated hospital. Single-center.

Patients: One hundred three patients scheduled for insertion of an IUD.

Interventions: Patients were randomly assigned to receive oral tramadol 50 mg capsules (n = 35) or naproxen sodium 550 mg tablets (n = 34) or placebo (n = 34) 1 hour before insertion of the IUD. After insertion of the IUD, pain intensity was evaluated using a visual analog scale (VAS, 0-10). Adverse effects, patient satisfaction with the medication, and preference for using it during future insertions were also recorded.

Measurements and main results: The VAS scores were significantly different during IUD insertion among the 3 groups (p = .001). Pain scores in the tramadol group were significantly lower than in the naproxen group (p = .003), and the scores in the naproxen group was significantly lower than in the control group (p = .001). Patient satisfaction with the medication and preference for its future use were significantly lower in the control group than in the other 2 groups (p = .001).

Conclusion: Prophylactic analgesia using 50 mg tramadol and 550 mg naproxen, delivered orally, can be used to relieve pain during IUD insertion. However, tramadol capsules were found to be more effective than naproxen tablets.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Analgesics, Opioid / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Humans
  • Intrauterine Devices*
  • Middle Aged
  • Naproxen / therapeutic use*
  • Pain / prevention & control*
  • Pain Measurement
  • Patient Satisfaction / statistics & numerical data
  • Tramadol / therapeutic use*
  • Treatment Outcome
  • Young Adult


  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Tramadol
  • Naproxen