Clonidine as an adjuvant to lignocaine infiltration for prolongation of analgesia after episiotomy

Abstract

Background:Epidural labor analgesia has not been fully accepted despite many advantages. Many times, the pregnant females reach hospital without antenatal checkup, and at that time, “episiotomy infiltration” becomes an ideal method for vaginal delivery. One of the most important problems after episiotomy is the severe perineal pain on the 1st day of postpartum period.Objectives:We compared the efficacy of clonidine 1 μg/kg as an adjuvant to 20 mg/ml lignocaine infiltration along the line of episiotomy incision for prolonging the duration and quality of analgesia with respect to various activities by single injection.Methodology:Majority of the patients, 94.2% in our study, had no idea about labor analgesia, and only 2.5% of all the patients expressed their interest to deliver without suffering from labor pains. One hundred and twenty pregnant female patients scheduled for full-term vaginal delivery were assigned into lignocaine and lignocaine-clonidine group according to infiltration they received. Pain scoring using visual analog scale and maternal satisfaction scale was monitored. At the end of the research project, the data were compiled and analyzed using appropriate statistical tests.Results:Duration of analgesia after episiotomy during sitting, walking, and squatting was 22.7 ± 1.32, 21.73 ± 1.47, and 19.875 ± 1.48 h in clonidine + lignocaine group and 6.06 ± 1.26, 5.33 ± 1.18, and 4.01 ± 1.28 h in lignocaine only group, respectively, which was highly statistically significant P < 0001.Conclusions:Clonidine when added to 2% lignocaine infiltration in episiotomy improves the quality and significantly enhances the duration of analgesia.

Pudendal nerve block versus usual lidocaine infiltration for pain relief in episiotomy repair: a comparative prospective study

“…Perineal trauma and hemorrhoids are associated with an increased pain intensity after childbirth [20,35], which concur with our results. Also, chronic pelvic pain due to some diseases such as endometriosis can cause more elevated level of pain [36,37].Other factors that may influence the severity of pain were not investigated in our study, such as information quality, psychological status [20], instrumental delivery [38], repair technique, suture type [39], ethnicity and education level [33].…”