1. Intervention summary.
| Study | Experimental intervention | Comparison intervention | Delivery | Timing before procedure | Parity |
| NSAID | |||||
| Massey 1974 | Naproxen 300 mg x 4 doses (+ paracervical block, 1% lidocaine, 8 mL) | Placebo (+ paracervical block, 1% lidocaine, 8 mL) | Tablet, oral | Previous night and 1.5 h prior; 2 and 6 h after | (96% nulliparous) |
| Karabayirli 2012 | Naproxen 550 mg | Placebo | Tablet | 1 h | Multiparous |
| Hubacher 2006 | Ibuprofen 400 mg | Placebo | Tablet, oral | ≥ 45 min | _ |
| Jensen 1998 | Ibuprofen 600 mg | Placebo | Tablet, oral | 1 to 4 h (also 4 to 6 h after) | _ |
| Bednarek 2015 | Ibuprofen 800 mg | Placebo | Tablet, oral | 30 to 45 min | (Requesting abortion) |
| Chor 2012 | Ibuprofen 800 mg | Placebo | Tablet, oral | 45 min | _ |
| Ngo 2014a | Ketorolac 30 mg | Saline | intramuscular injection | 30 min | _ |
| Lidocaine | |||||
| Mohammad‐Alizadeh‐C 2010 | 2% gel (amount unspecified) | Lubricant gel or no intervention | Swab | > 1 min | _ |
| Maguire 2012 | 2% gel (1 mL) | Placebo gel | Swab | prior to uterine sounding | _ |
| Allen 2013 | 2% gel (6 mL) | Placebo gel | 2 sites, 3 mL each, via syringe | 3 min | _ |
| McNicholas 2012 | 2% gel (2.5 to 4 mL) | Placebo gel | 0.5 to 1 mL topical; 2 to 3 mL inserted | 3 min | Randomization stratified by parity |
| Rapkin 2014a | 2% gel (5 mL) | Placebo gel | Self‐inserted vaginally | 5 min | Nulliparous |
| Nelson 2013 | 2% (1.2 mL) | Saline placebo | Infused, 3 sites | 3 min | _ |
| Tornblom‐Paulander 2015 | 4% gel (8.5 mL) | Placebo | Topical, 3 sites | 5 min | Nulliparous |
| Aksoy 2015 | 10% spray (40 mg) | Saline placebo | Topical, 2 sites; 4 puffs total | 3 min | Parous |
| Ahmadi Doulabi 2013 | EMLA cream 5% (lidocaine + prilocaine) (5 g) | Placebo cream | Swab on cervix and cervical opening | 7 min | _ |
| Mody 2012 | 1% paracervical block (10 mL) | No analgesia (no intervention) | 2 sites, 5 mL each | 3 min | _ |
| Cırık 2013 | 1% paracervical block (10 mL) | Saline or no intervention | 2 sites, 5 mL each | 5 min | _ |
| Castro 2014 | 2% intracervical block (1.8 mL) | Ibuprofen 400 mg | 4 sites | 5 min (lidocaine); 1 h (ibuprofen) | Nulliparous or no vaginal delivery |
| Misoprostol | |||||
| Sääv 2007 | 400 μg + diclofenac | Diclofenac | Sublingual | 1 h | Nulliparous |
| Ibrahim 2013 | 400 µg + diclofenac | Diclofenac | Sublingual | 1 h | Prior cesarean delivery only |
| Heikinheimo 2010 | 400 µg | Placebo | Sublingual | 3 h | _ |
| Edelman 2011 | 400 µg | Placebo | Buccal | 90 min | Nulliparous |
| Lathrop 2013 | 400 µg | Placebo | Buccal | 2 to 4 h | No pregnancy > 19 6/7 weeks |
| Espey 2014 | 400 µg | Placebo | Buccal | 2 to 8 h | Nulliparous |
| Lotke 2013 | 400 μg | Placebo | Vaginal or buccal | 2 h | Nulliparous |
| Swenson 2012 | 400 μg | Placebo | Vaginal or buccal | 3 to 4 h | No pregnancy > 13 6/7 weeks |
| Dijkhuizen 2011 | 400 μg | Placebo | Vaginal | 3 h | _ |
| Scavuzzi 2013 | 400 μg | Placebo | Vaginal | 4 h | Nulligravida |
| Other | |||||
| Bednarek 2013 | Nitroprusside gel 1% | Placebo gel | 1 mL | immediately prior | Nulliparous |
| Micks 2014 | Nitroglycerin ointment 0.5 mg | Placebo ointment | 1 mL | 35 to 40 min | Nulliparous |
| Karabayirli 2012 | Tramadol 50 mg | Naproxen 550 mg | Tablet | 1 h | Multiparous |
| Shahnazi 2012 | Lavender 10 drops in diluted milk | Diluted milk | 3 drops on cotton, inhaled | 30 min (also during) | _ |
| Cameron 2013 | Bladder emptying delayed (after IUC insertion) | Bladder emptying immediate (before IUC insertion) | Water 1L, orally, 1 h before appointment | _ | _ |
aNo full report; sources included conference abstract and clinical trial listing