to the editor: We were pleased to see Harde-man and Weiss' recent update on intrauterine devices (IUDs).They addressed many common misconceptions about IUDs, including use in adolescents, in patients who are nul-liparous, and in patients with a history of sexually transmitted infection. The authors did not mention use of lidocaine during IUD insertion, either topically or via cervical block. Cervical lidocaine has been used for pain control for multiple outpatient gynecologic procedures, including colposcopy, endometrial biopsy, hysteroscopy, and cervical dilation and aspiration.Although the available evidence is somewhat mixed, the risk of harm is low, with a primary risk of pain, bleeding, and vasovagal symptoms with injected lidocaine.
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