title: Lidocaine versus ropivacaine for perineal infiltration post-episiotomy.
abstract: 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 10mg/mL; period B, 20 mL of ropivacaine 7.5mg/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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Anesthesia and Reanimation, APHM Hôpital Nord, Marseille, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Gutton
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bellefleur
authors.forename: Séverine
authors.initials: S
authors.lastname: Puppo
authors.forename: Julie
authors.initials: J
authors.lastname: Brunet
authors.forename: Francois
authors.initials: F
authors.lastname: Antonini
authors.forename: Marc
authors.initials: M
authors.lastname: Leone
authors.forename: Florence
authors.initials: F
authors.lastname: Bretelle
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage / Q000627:therapeutic use*; D016362:Analgesia, Obstetrical / Q000379:methods; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D016022:Case-Control Studies; D004841:Episiotomy / Q000379:methods*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008137:Longitudinal Studies; D010147:Pain Measurement; D017060:Patient Satisfaction; D010502:Perineum; D011247:Pregnancy; D011446:Prospective Studies; D000077212:Ropivacaine; D016037:Single-Blind Method; D013997:Time Factors; D055815:Young Adult
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D008012:Lidocaine