Effectiveness and acceptability of lidocaine spray in reducing perineal pain during spontaneous vaginal delivery: randomised controlled trial.
OBJECTIVE
To evaluate the effectiveness and acceptability of a lidocaine spray in reducing perineal pain during spontaneous vaginal delivery.


METHODS
Randomised controlled trial.


METHODS
Consultant led obstetric unit.


METHODS
185 women who had a spontaneous vaginal delivery without epidural analgesia.


METHODS
Topically applied local anaesthetic spray (93 women) and placebo spray (92 women).


METHODS
Primary outcome measure was pain during delivery (0-100 scale). The 16 secondary outcome measures included second degree perineal trauma during delivery, trauma of the genital tract, and dyspareunia by two months.


RESULTS
Lidocaine spray did not reduce pain during spontaneous vaginal delivery: mean 77 and 72 on a scale of 0-100 in the lidocaine and placebo groups, respectively (difference between means 4.8, 95% confidence interval -1.7 to 11.2). Lidocaine spray may reduce genital tract trauma during delivery, in particular second degree perineal trauma. The intervention was highly acceptable to the women and midwives.


CONCLUSIONS
Although lidocaine spray applied to the perineum during spontaneous vaginal delivery did not reduce perineal pain, it was acceptable to both the women and the midwives.


BACKGROUND
Current controlled trials ISRCTN99732966 [controlled-trials.com].
Sanders
Julia
J
Department of Social Medicine, University of Bristol, Bristol BS8 2PR. julia.sanders@cardiffandvale.wales.nhs.uk
Campbell
Rona
R
Peters
Tim J
TJ
D000287:Administration, Topical; D016362:Analgesia, Obstetrical / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D007744:Obstetric Labor Complications / Q000517:prevention & control*; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D011247:Pregnancy; D016896:Treatment Outcome
D000779:Anesthetics, Local; D008012:Lidocaine