Management of Nexplanon Insertion Site Pain

Pre-Procedure Pain Prevention

The American College of Obstetricians and Gynecologists recommends administering naproxen 500-550 mg orally 1-2 hours before insertion to optimize pain control 1
Ibuprofen 800 mg orally 1-2 hours before insertion serves as an effective alternative if naproxen is contraindicated 1
Ketorolac 20 mg orally 40-60 minutes before insertion provides faster onset for patients requiring more rapid analgesia 1, 3

Providing low lighting and slow-rhythm music can reduce anxiety and pain perception 1, 2
Applying warm towels to the arm can promote vasodilation and comfort 1, 2
Using trauma-informed language and explaining each step before proceeding can allow the patient to feel in control 1, 3

Keeping the patient's arm in a comfortable position for 5 minutes after insertion can prevent vasovagal reactions 5, 2
Applying acupressure bilaterally at Large Intestine-4 (LI4) or Spleen-6 (SP6) points can reduce cramping and discomfort 5, 2
Offering a cold compress or ice pack to the insertion site can reduce swelling and provide comfort 1, 2
Providing a beverage and snack can help prevent vasovagal symptoms 5, 2
Naproxen 440-550 mg every 12 hours with food is the preferred regimen for post-insertion pain control 1, 2
Ibuprofen 600-800 mg every 6-8 hours with food serves as an alternative NSAID option 1, 2

Avoid combining NSAIDs with other anticoagulants without appropriate monitoring 1