Comparison between lidocaine-prilocaine cream (EMLA) and mepivacaine infiltration for pain relief during perineal repair after childbirth: a randomized trial.
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.


METHODS
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)


CONCLUSIONS
EMLA cream appears to be an effective and satisfactory alternative to local anesthetic infiltration for the relief of pain during perineal repair.
Franchi
Massimo
M
Department of Obstetrics and Gynecology, University of Verona, Verona, Italy.
Cromi
Antonella
A
Scarperi
Stefano
S
Gaudino
Francesca
F
Siesto
Gabriele
G
Ghezzi
Fabio
F
D000287:Administration, Topical; D000328:Adult; D019162:Anesthetics, Combined / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D036861:Delivery, Obstetric / Q000009:adverse effects; D004841:Episiotomy; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D000077442:Lidocaine, Prilocaine Drug Combination; D008619:Mepivacaine / Q000008:administration & dosage; D010146:Pain / Q000188:drug therapy*; D036801:Parturition; D017060:Patient Satisfaction; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D011318:Prilocaine / Q000008:administration & dosage*; D013537:Sutures; D014622:Vaginal Creams, Foams, and Jellies
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D014622:Vaginal Creams, Foams, and Jellies; D011318:Prilocaine; D008012:Lidocaine; D008619:Mepivacaine