EMLA cream and intraperitoneal lidocaine decrease intraoperative pain during postpartum tubal sterilization.
We conducted a randomized, double blinded, placebo controlled trial to evaluate the effectiveness of EMLA cream together with intraperitoneal lidocaine for pain relief in postpartum tubal ligation. In a factorial designed study, 90 postpartum patients were randomly assigned to have 5 g of EMLA or placebo cream applied to the skin in 2 groups of 45 patients and to have intraperitoneal instillation of 20 ml of either 1 per cent, 2 per cent lidocaine or normal saline in 3 groups of 30 patients. A numerical rating pain score (0-10) was used during skin check, skin infiltration and uterine tube manipulation. The pain scores were significantly lower in the EMLA group as compared with the placebo group during the skin forceps check (p < 0.001) and during local skin infiltration (p < 0.05). The pain scores were also significantly lower during intraabdominal manipulation in the group using either 1 per cent or 2 per cent intraperitoneal lidocaine as compared with the group using normal saline (p < 0.001), but no difference was found between the groups using 1 per cent and 2 per cent lidocaine.


CONCLUSIONS
Five g of EMLA cream applied to the skin together with 20 ml of 1 per cent lidocaine instilled into the abdominal cavity effectively decrease intraoperative pain in patients undergoing postpartum tubal sterilization under local anesthesia.
Visalyaputra
Shusee
S
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Pethpaisit
Nuchsaroch
N
Ariyanon
Premrudee
P
Parakkamodom
Sudta
S
Permpolprasert
Ludda
L
Apidechakul
Parichad
P
Latthikaviboon
Umaporn
U
Limsakul
Aticha
A
Santivarangkana
Taweesak
T
Sirilertmakasakul
Preyapa
P
D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal; D007431:Intraoperative Complications / Q000188:drug therapy*; D008012:Lidocaine / Q000008:administration & dosage*; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D010146:Pain / Q000188:drug therapy*; D049590:Postpartum Period; D011247:Pregnancy; D011318:Prilocaine / Q000008:administration & dosage*; D018709:Statistics, Nonparametric; D013246:Sterilization, Tubal; D016896:Treatment Outcome
D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine