Sheida Shabanian1, Sara Kalbasi2, Gholamreza Shabanian3, Bahram Khoram4, Forozan Ganji5. 1. Assistant Professor, Department of Obstetrics and Gynaecology, Shahrekord University of Medical Sciences, Shahrekord, Iran. 2. Gynaecologist, Ardestan Hospital, Ardestan University of Medical Sciences, Ardestan, Iran. 3. Assistant Professor, Department of Anaesthesiology, Shahrekord University of Medical Sciences, Shahrekord, Iran. 4. Anesthesiologist, Shahrekord University of Medical Sciences, Shahrekord, Iran. 5. Associate Professor, Department of Community Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Abstract
INTRODUCTION: Episiotomy is the most common procedure used for dilatation of the vaginal opening for giving birth. Although episiotomy is associated with benefits for the mother, it may lead to short term and long term disabilities, including postpartum perineal pain that is secondary to perineal tearing. AIM: The aim of this study was to investigate the effect of subcutaneous lidocaine compared with lidocaine and metoclopramide on pain after episiotomy. MATERIALS AND METHODS: In this clinical trial study, the patients (83 for control group and 83 for case group) with episiotomy Grades II and III were enrolled and were asked to express their postpartum episiotomy pain as a number, from zero (no pain) to 10 (severest pain) Visual Analogue Scale (VAS score) at 0, 30 minute, 1 hour, 2 hour, 4 hour, 6 hour and 12 hour postpartum. Patients at the second stage of labour (crowning) were assigned to two groups: In the control group, 5 cc lidocaine 2% and in the case group, 5 cc lidocaine + 10 mg metoclopramide was injected for episiotomy. Then, the pain score was compared between the two groups. The data were analyzed by t-test and chi-square test with software SPSS version 20.0. RESULTS: Mean age of the women was 23.19±0.46 years in the control group and 23.96±0.58 years in the case group with no significant difference between the two groups (p<0.05). The mean pain score in the control group was 3.54±0.71 and in the case group 2.93±0.91 at 30 minutes after the injection, with a statistically significant difference. At other intervals, postnatal pain scores in the case group was lower than those of the control group (p<0.05). CONCLUSION: Injection of metoclopramide with lidocaine is more effective than lidocaine alone for relieving the pain after episiotomy.
RCT Entities:
INTRODUCTION: Episiotomy is the most common procedure used for dilatation of the vaginal opening for giving birth. Although episiotomy is associated with benefits for the mother, it may lead to short term and long term disabilities, including postpartum perineal pain that is secondary to perineal tearing. AIM: The aim of this study was to investigate the effect of subcutaneous lidocaine compared with lidocaine and metoclopramide on pain after episiotomy. MATERIALS AND METHODS: In this clinical trial study, the patients (83 for control group and 83 for case group) with episiotomy Grades II and III were enrolled and were asked to express their postpartum episiotomy pain as a number, from zero (no pain) to 10 (severest pain) Visual Analogue Scale (VAS score) at 0, 30 minute, 1 hour, 2 hour, 4 hour, 6 hour and 12 hour postpartum. Patients at the second stage of labour (crowning) were assigned to two groups: In the control group, 5 cc lidocaine 2% and in the case group, 5 cc lidocaine + 10 mg metoclopramide was injected for episiotomy. Then, the pain score was compared between the two groups. The data were analyzed by t-test and chi-square test with software SPSS version 20.0. RESULTS: Mean age of the women was 23.19±0.46 years in the control group and 23.96±0.58 years in the case group with no significant difference between the two groups (p<0.05). The mean pain score in the control group was 3.54±0.71 and in the case group 2.93±0.91 at 30 minutes after the injection, with a statistically significant difference. At other intervals, postnatal pain scores in the case group was lower than those of the control group (p<0.05). CONCLUSION: Injection of metoclopramide with lidocaine is more effective than lidocaine alone for relieving the pain after episiotomy.
Authors: Jean-Pierre Estèbe; Marc E Gentili; Grégoire Langlois; Philippe Mouilleron; Franck Bernard; Claude Ecoffey Journal: Reg Anesth Pain Med Date: 2003 Mar-Apr Impact factor: 6.288