Comparison between lidocaine-prilocaine cream (EMLA) and mepivacaine infiltration for pain relief during perineal repair after childbirth: a randomized trial
Received 28 September 2008; received in revised form 23 November 2008; accepted 9 April 2009. published online 29 June 2009.
Objective
The purpose of this study was to compare the effectiveness of topically applied lidocaine-prilocaine (EMLA) cream with local anesthetic infiltration in the reduction of pain during perineal suturing after childbirth.
Study Design
Sixty-one women with either an episiotomy or a perineal laceration after vaginal delivery were assigned randomly to receive either the application of EMLA cream (n = 31) or infiltration with mepivacaine (n = 30) before perineal suturing. Primary outcome was pain during perineal repair.
Results
Women in the EMLA group had lower pain scores than those in the mepivacaine group (1.7 ± 2.4 vs 3.9 ± 2.4; P = .0002). The proportion of women who needed additional anesthesia was similar in the 2 groups (3/30 vs 5/31; P = .71). A significantly higher proportion of women expressed satisfaction with anesthesia method in the EMLA group, compared with the mepivacaine group (83.8% vs 53.3%; P = .01)
Conclusion
EMLA cream appears to be an effective and satisfactory alternative to local anesthetic infiltration for the relief of pain during perineal repair.
aDepartment of Obstetrics and Gynecology, University of Verona, Verona, Italy
bDepartment of Obstetrics and Gynecology, University of Insubria, Varese, Italy
Reprints: Fabio Ghezzi, MD, Department of Obstetrics and Gynecology, University of Insubria, Piazza Biroldi 1, 21100 Varese, Italy
Cite this article as: Franchi M, Cromi A, Scarperi S, et al. Comparison between lidocaine-prilocaine cream (EMLA) and mepivacaine infiltration for pain relief during perineal repair after childbirth: a randomized trial. Am J Obstet Gynecol 2009;201:186.e1-5.
Authorship and contribution to the article is limited to the 6 authors indicated. There was no outside funding or technical assistance with the production of this article.
ABSTRACT
Comparison between lidocaine-prilocaine cream (EMLA) and mepivacaine infiltration for pain relief during perineal repair after childbirth: a randomized trial