Vulvar application of lidocaine for pain relief in spontaneous vaginal delivery.
OBJECTIVE
To evaluate the effect of topical perineal lidocaine on immediate postpartum perineal pain.


METHODS
Two hundred three volunteers randomly received either 2% lidocaine jelly or chlorhexidine gluconate topically to the perineum during the second stage of labor in a double-blind study. A four-point analogue pain scale was used to rate perineal pain 30 minutes after delivery. Parametric data were evaluated with the unpaired Student t test. Nonparametric data were analyzed using Mann-Whitney, Pearson chi 2, and Mantel-haenzel tests, and forward stepwise logistic regression.


RESULTS
Women receiving topical lidocaine reported less overall perceived pain (48%, P < .05) and less moderate to severe pain (52%, odds ratio 1.83, P < .04) at delivery than those receiving placebo (33 and 67%, respectively). The incidence of perineal lacerations was similar in the two groups. A logistic regression found topical lidocaine and multiparity as significant correlates of diminished peripartum pain (P < .007).


CONCLUSIONS
Topical application of 2% lidocaine gel was associated with decreased pain perception in the immediate postpartum interval. If confirmed by other investigators, this technique may offer improved analgesia while minimizing the injection route with local analgesia.
Collins
M K
MK
Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa.
Porter
K B
KB
Brook
E
E
Johnson
L
L
Williams
M
M
Jevitt
C M
CM
D000287:Administration, Topical; D016362:Analgesia, Obstetrical; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D036861:Delivery, Obstetric; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007748:Labor Stage, Second; D008012:Lidocaine / Q000008:administration & dosage*; D016015:Logistic Models; D010147:Pain Measurement; D010298:Parity; D011247:Pregnancy; D014844:Vulva
D008012:Lidocaine; C010882:chlorhexidine gluconate; D002710:Chlorhexidine