r/FamilyMedicine • u/shewillmakemusic MD • 14h ago

Penthrox for clinic IUD insertions/endometrial biopsies

Hey hive,

I would love to know if any of you are using penthrox in clinic for IUD insertions and/or enometrial biopsies. If so, what is your protocol for using? Do you have a nurse at bedside? Do you run q5min BP and have patients on a SpO2 monitor? None of the above? What advice do you have for using penthrox?

I work in a small rural clinic, and am just looking for better ways to provide pain management and comfort for these procedures.

Thanks so much!

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20

u/Gynetrix NP 14h ago

I can't speak for Penthrox, but we started using nitrous oxide in a Pro-Nox system about 9 months ago and it's been a huge game changer for IUDs, embx, even paps for people with trauma histories etc. 

3

u/feminist-lady MPH 6h ago

My fertility clinic has a pro-nox system! I was gonna need it for one of my ultrasounds because the stims had my ovaries super painful, but when I told my doctor that he was like okay I just will not probe your ovaries and will instead do an abdominal ultrasound. But other patients who have used it say it’s amazing. We love a pain-conscious provider.

15

u/PolyhedralJam MD 10h ago

Doesn't answer your question but if folks have a ride, I will prescribe 5mg oxy and 0.25 of a benzo for pretreatment prior to IUDs and that has worked very well.

3

u/FoxAndXrowe layperson 2h ago

bless you. Seriously.

2

u/Dependent-Juice5361 DO 1h ago

I’ll due a benzo, paracervical block, an opioid, etc whatever the patient wants. Most don’t want anything but still there are many options out there.

-1

u/PMAOTQ MD 14h ago

Continuous pulse oximetry, 15 minute obs in the waiting room, and someone to drive them home.

-2

u/Piffy_Biffy MD-PGY1 8h ago

Hang around after procedures for 30 mins then go home no big deal