Objective  To evaluate the preemptive analgesic effect of diclofenac sodium combined with tramadol in outpatient intrauterine device (IUD) removal surgery for postmenopausal women, and to explore its feasibility and effectiveness in clinical application.

Methods  The clinical data of postmenopausal women who underwent IUD removal surgery at the obstetrics and gynecology outpatient department of the Hunan Schistosomiasis Prevention and Control Institute from February 2022 to January 2023 were retrospectively collected. A propensity score matching (PSM) method for 1:1 matching was applied. The combination group received diclofenac sodium suppositories combined with tramadol for analgesia, while the control group received diclofenac sodium suppositories combined with lidocaine. Surgical duration, analgesic effect, adverse reactions, cervical softening, and success rate of IUD removal were compared between the two groups.

Results  Data from 142 patients were collected. After PSM, there were 53 patients in each group. The surgery time in the combination group was significantly shorter than in the control group (2.58±0.51 vs. 4.76±1.37 minutes, P<0.001). The numeric rating scale (NRS) scores in the combination group was better than in the control group (1.43±0.75 vs. 3.87±1.33, P<0.001). The cervical softening rate in the combination group was 94.34%, significantly higher than the 71.70% in the control group (P<0.05),while the success rate of IUD removal in the combination group was 96.23%, also significantly higher than 84.91% in the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusion  Diclofenac sodium combined with tramadol provides significant preemptive analgesic effects in IUD removal surgery for postmenopausal women. It helps to shorten surgical duration, alleviate intraoperative pain, promote cervical softening, and increase the success rate of IUD removal, demonstrating high clinical value.

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