Pudendal nerve block vs usual lidocaine infiltration for pain relief in episiotomy repair: a comparative prospective study

Q3 Medicine

Italian Journal of Gynaecology and Obstetrics Pub Date : 2023-05-01 DOI:10.36129/jog.2023.122

E. Yasmine, J. Melek, C. Ali, A. Marwa, D. Mohamed, C. Kais, J. Anouar, K. Kamel

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Abstract

Objective. we aimed to compare the anesthetic and analgesic effect of the pudendal nerve block (PNB) and of the local lidocaine infiltration during episiotomy repair and in the following 24 hours. Patients and Methods. 70 parturients undergoing natural birth requiring episiotomy and presenting contraindication or refusal of epidural analgesia were randomized to receive pudendal nerve block with ropivacaine or local lidocaine infiltration. The main endpoint was: evaluation of obstetric analgesia by visual analogical scale . The secondary judgment criteria were: hemodynamic parameters, suture duration, onset time of sensory block, time to first analgesic request, rehabilitation parameters, parturient and obstetrician satisfaction and pain intensifying factors. Results. Mean VAS pain score was significantly lower in pudendal group versus infiltration group at T10min(10 minutes after local anesthetic injection) (7.20±8.56 vs. 20.43±18.25, p<0.01), T15min (5.43±8.17 vs. 17.71±16.42, p<0.01), T20min(repair starting) (29.63±23.59 vs. 44.06±28.16, p=0.023), T1h (13.14±19.18 vs. 32.20±21.25, p<0.01), T1h30min (10.57±14.74 vs. 27.34±16.74, p<0.01) and T2h (9.57±15.69 vs. 25.34±16.32, p<0.01), T6h (13.57±14.07 vs. 41.43±23.24, p<0.01), T12h (22.60±20.41 vs. 36.49±23.35, p=0.010) and T18h (12.23±11.84 vs. 27.94±23.40

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外阴神经阻滞与常规利多卡因浸润缓解会阴切开术修复中的疼痛:一项比较前瞻性研究

目标。我们的目的是比较外阴神经阻滞(PNB)和局部利多卡因浸润在会阴切开术修复期间和术后24小时内的麻醉和镇痛效果。患者和方法:70例自然分娩需要外阴切开术且有禁忌症或拒绝硬膜外镇痛的产妇，随机分为罗哌卡因或局部利多卡因浸润阴部神经阻滞组。主要终点为:用视觉类比量表评价产科镇痛效果。次要判断标准为:血流动力学参数、缝合时间、感觉阻滞发生时间、到达首次镇痛要求时间、康复参数、母婴满意度和疼痛加剧因素。结果。阴部组VAS平均疼痛评分在T10min(局麻注射后10min)(7.20±8.56比20.43±18.25,p<0.01)、T15min(5.43±8.17比17.71±16.42,p<0.01)、T20min(修复开始)(29.63±23.59比44.06±28.16,p=0.023)、T1h(13.14±19.18比32.20±21.25,p<0.01)、T1h30min(10.57±14.74比27.34±16.74,p<0.01)、T2h(9.57±15.69比25.34±16.32,p<0.01)、T6h(13.57±14.07比41.43±23.24,p<0.01)显著低于浸润组。T12h(22.60±20.41∶36.49±23.35,p=0.010)和T18h(12.23±11.84∶27.94±23.40)

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来源期刊

Italian Journal of Gynaecology and Obstetrics Medicine-Obstetrics and Gynecology

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： Presentazione: E’ l’organo ufficiale della Società Italiana di Ginecologia e Ostetricia. Con cadenza trimestrale pubblica articoli originali su temi di anatomia, istologia, fisiologia, patologia, genetica e virologia dell’apparato genitale femminile. Propone, inoltre, casi clinici riguardanti valutazioni di tecniche chirurgiche e trattamenti terapeutici; editoriali e review; il punto di vista di eminenti autori su particolari tematiche sotto l’aspetto etico e clinico.