Julia Sanders1, Rona Campbell, Tim J Peters. 1. Department of Social Medicine, University of Bristol, Bristol BS8 2PR. julia.sanders@cardiffandvale.wales.nhs.uk
Abstract
OBJECTIVES: To evaluate the effectiveness and acceptability of a lidocaine spray in reducing perineal pain during spontaneous vaginal delivery. DESIGN: Randomised controlled trial. SETTING: Consultant led obstetric unit. PARTICIPANTS: 185 women who had a spontaneous vaginal delivery without epidural analgesia. INTERVENTIONS: Topically applied local anaesthetic spray (93 women) and placebo spray (92 women). MAIN OUTCOME MEASURE: Primary outcome measure was pain during delivery (0-100 scale). The 16 secondary outcome measures included second degree perineal trauma during delivery, trauma of the genital tract, and dyspareunia by two months. RESULTS:Lidocaine spray did not reduce pain during spontaneous vaginal delivery: mean 77 and 72 on a scale of 0-100 in the lidocaine and placebo groups, respectively (difference between means 4.8, 95% confidence interval -1.7 to 11.2). Lidocaine spray may reduce genital tract trauma during delivery, in particular second degree perineal trauma. The intervention was highly acceptable to the women and midwives. CONCLUSIONS: Although lidocaine spray applied to the perineum during spontaneous vaginal delivery did not reduce perineal pain, it was acceptable to both the women and the midwives. TRIAL REGISTRATION: Current controlled trials ISRCTN99732966 [controlled-trials.com].
RCT Entities:
OBJECTIVES: To evaluate the effectiveness and acceptability of a lidocaine spray in reducing perineal pain during spontaneous vaginal delivery. DESIGN: Randomised controlled trial. SETTING: Consultant led obstetric unit. PARTICIPANTS: 185 women who had a spontaneous vaginal delivery without epidural analgesia. INTERVENTIONS: Topically applied local anaesthetic spray (93 women) and placebo spray (92 women). MAIN OUTCOME MEASURE: Primary outcome measure was pain during delivery (0-100 scale). The 16 secondary outcome measures included second degree perineal trauma during delivery, trauma of the genital tract, and dyspareunia by two months. RESULTS:Lidocaine spray did not reduce pain during spontaneous vaginal delivery: mean 77 and 72 on a scale of 0-100 in the lidocaine and placebo groups, respectively (difference between means 4.8, 95% confidence interval -1.7 to 11.2). Lidocaine spray may reduce genital tract trauma during delivery, in particular second degree perineal trauma. The intervention was highly acceptable to the women and midwives. CONCLUSIONS: Although lidocaine spray applied to the perineum during spontaneous vaginal delivery did not reduce perineal pain, it was acceptable to both the women and the midwives. TRIAL REGISTRATION: Current controlled trials ISRCTN99732966 [controlled-trials.com].
Authors: R H Petrie; W L Paul; F C Miller; J J Arce; R H Paul; R M Nakamura; E H Hon Journal: Am J Obstet Gynecol Date: 1974-11-15 Impact factor: 8.661