A randomized controlled trial of lidocaine versus ropivacaine for pain relief after episiotomy

Asis Adhikary, Papiya Biswas, T. Mondal, S. Bhattacharyya
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Abstract

Introduction: Episiotomy is the most common surgical procedure for parturient. Analgesia after episiotomy has received less attention, though the postepisiotomy pain may hamper the day-to-day activities such as sitting, sleeping, urinating, and walking of the parturient. It is desirable to reduce the postepisiotomy pain as early as possible. Therefore, we planned to carry out a randomized controlled trial to compare the safety and efficacy of lidocaine versus ropivacaine perineal infiltration for pain relief after episiotomy. Materials and Methods: The prospective randomized controlled trial was conducted in the Department of Obstetrics and Gynaecology of R. G. Kar Medical College and Hospital, Kolkata. One hundred women were enrolled and randomized into the two groups: Lidocaine infiltration group and ropivacaine infiltration group. Primary objective was to evaluate the efficacy of postepisiotomy pain control by the visual analog scale (VAS) score at 24 h after the episiotomy. Secondary objectives were to evaluate the efficacy of postepisiotomy pain control by VAS score during suturing, at 2 h and 48 h or any adverse effects and maternal satisfaction at 48 h. Results: The postepisiotomy pain relief at 2 h and 24 h was significantly lower in ropivacaine in comparison to lidocaine infiltration. Mean VAS Score 24 h after suturing in lidocaine group was 6.38, and in ropivacaine group, it was 5.64. Maternal pain perception at the time of suturing and at 48 h was also less in ropivacaine than in lidocaine infiltration. Mothers were more satisfied with ropivacaine drug. Conclusion: The present study showed that there was definite improvement of postepisiotomy pain relief at 2 h and 24 h in ropivacaine local infiltration of the episiotomy wound in comparison to lidocaine infiltration and mothers were more satisfied with ropivacaine use.
利多卡因与罗哌卡因缓解会阴切开术后疼痛的随机对照试验
简介:会阴切开术是产妇最常见的外科手术。尽管会阴切开术后的疼痛可能会阻碍产妇的日常活动,如坐、睡、尿和走路,但会阴切开术的镇痛作用却很少受到关注。希望尽早减轻会阴切开术后的疼痛。因此,我们计划进行一项随机对照试验,比较利多卡因和罗哌卡因会阴浸润缓解会阴切开术后疼痛的安全性和有效性。材料和方法:前瞻性随机对照试验在加尔各答R.G.Kar医学院妇产科进行。将100名女性随机分为两组:利多卡因渗透组和罗哌卡因渗透组。主要目的是通过在会阴切开术后24小时的视觉模拟量表(VAS)评分来评估会阴切开后疼痛控制的疗效。次要目的是通过缝合过程中2小时和48小时的VAS评分或任何不良反应和48小时产妇满意度来评估会阴切开术后疼痛控制的疗效。结果:与利多卡因浸润相比,罗哌卡因在2小时和24小时的会阴切开后疼痛缓解显著较低。利多卡因组缝合后24小时的平均VAS评分为6.38,罗哌卡因组为5.64。在缝合时和48小时时,罗哌卡因的母体疼痛感也低于利多卡因浸润。母亲们对罗哌卡因药物更满意。结论:本研究表明,与利多卡因浸润相比,罗哌卡因对会阴切开伤口的局部浸润在2小时和24小时的会阴切开后疼痛缓解有明显改善,母亲对罗哌卡因的使用更满意。
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