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Lidocaine versus ropivacaine for perineal infiltration post‐episiotomy
Author(s) -
Gutton Christophe,
Bellefleur JeanPierre,
Puppo Séverine,
Brunet Julie,
Antonini Francois,
Leone Marc,
Bretelle Florence
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2013.01.028
Subject(s) - ropivacaine , medicine , episiotomy , lidocaine , visual analogue scale , anesthesia , pregnancy , biology , genetics
Objective To evaluate maternal analgesia after an episiotomy during delivery. Methods The present case–control study compared 2 protocols of post‐episiotomy infiltration: period A, 20 mL of lidocaine 10 mg/mL; period B, 20 mL of ropivacaine 7.5 mg/mL. The primary study endpoint was the visual analog scale (VAS) score at 24 hours after episiotomy; secondary endpoints were the VAS scores during suturing and at 2 and 48 hours, and patient satisfaction at 48 hours. Results In total, 102 women were included in the study. The median VAS score at 24 hours was significantly lower during the ropivacaine period (3 [1.5–4]) than during the lidocaine period (4 [2–6]; P = 0.004). A VAS score below 4 at 24 hours was significantly more frequent with ropivacaine (71% versus 43%; P = 0.009). The VAS scores at 2 and 48 hours were also lower in the ropivacaine group (2 hours, 0 [0–1] versus 1 [0–3], P = 0.01; and 48 hours, 2 [0–3] versus 3 [2–5], P < 0.001). Maternal satisfaction was significantly higher in the ropivacaine group. Conclusion Analgesia and maternal satisfaction were improved during the period when ropivacaine was used as opposed to lidocaine. The effect lasted for up to 48 hours.