Douleur périnéale du post-partum : intérêt de l’infiltration locale de ropivacaïne

Sillou, S.; Carbonnel, Marie; N’Doko, S; Dhonneur, Gilles; Uzan, M.; Poncelet, Christophe

doi:10.1016/j.jgyn.2009.03.008

Cited by 12 publications

(19 citation statements)

References 19 publications

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“…[67] Ropivacaine has been shown to be superior to lignocaine for various reasons. [8911] It reduces postoperative opioid consumption after herniorrhaphy, thyroidectomy, hysteroscopy, and laparoscopic surgeries. [12131415] In addition, it also useful in suppression of inflammation, and the prevention of secondary hyperalgesia.…”

Section: Discussionmentioning

confidence: 99%

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Lignocaine versus ropivacaine infiltration for postpartum perineal pain

Deshpande

Saundattikar

2017

Anesth Essays Res

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Background:Millions of women worldwide undergo postpartum perineal repair under local infiltration. Inadequate postpartum pain management can negatively impact a mother's physical and psychological recovery.Aims:To study and compare the analgesic effect and maternal satisfaction with lignocaine versus ropivacaine infiltration for postpartum perineal pain relief.Materials and Methods:After clearance from the Institutional Ethics Committee, a double-blind prospective randomized study carried out on 100 parturients of aged 18–40 years who had spontaneous vaginal delivery, comparing 1% lignocaine and 0.75% ropivacaine infiltration for the repair of selective episiotomy or perineal injury. Time of the first analgesic (TFA) demand, maternal satisfaction at 24 h, and visual analog scale (VAS) pain score were studied.Statistical Analysis:Chi-square test and Student's t-test were used and P < 0.05 was considered as significant.Results:VAS pain score was significantly lower at 2 and 4 h in ropivacaine group versus lignocaine group (P < 0.0001). Significantly, longer TFA (10.2 ± 1.54 vs. 2.20 ± 0.44 h, P < 0.0001) and higher percentage of maternal satisfaction (86% vs. 44%) were observed in ropivacaine as compared to lignocaine group (P < 0.0001).Conclusions:Prolonged analgesia and higher rate of maternal satisfaction were found when ropivacaine infiltration was used for perineal repair as compared to lignocaine.

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Section: Discussionmentioning

confidence: 99%

“…[5] Ropivacaine has been widely used for local infiltration but less for postpartum perineal infiltration. [6789] Hence, we decided to compare the lignocaine and ropivacaine for postpartum perineal repair to observe maternal analgesia and satisfaction.…”

Section: Introductionmentioning

confidence: 99%

Lignocaine versus ropivacaine infiltration for postpartum perineal pain

Deshpande

Saundattikar

2017

Anesth Essays Res

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“…The patient should rate their pain on a de ned scale ranging from 0 to 10 where 0 is no pain and 10 is the worst pain imaginable. This scale has already been used in several studies that assessed perineal pain after episiotomy [29,31].…”

Section: Outcomes Measures Primary Outcome Measurementioning

confidence: 99%

“…Three studies have already studied the analgesic e cacy of ropivacaine in perineal in ltration after episiotomy [27][28][29]. Gutton and al [27] found a signi cant decrease of pain measured by a Visual Analogic Scale (VAS) at 24 hours in a cohort of 102 women in the ropivacaine group [3 with 95% CI 1.5 to 4] versus lidocaine group [4 with 95% CI 2 to 6] p = 0.004.…”

Section: Introductionmentioning

confidence: 99%

“…These results remained at 48 hours. In an unblinded study, Sillou and al [29] compared the injection of ropivacaine in the margin of the episiotomy (n = 31) to the absence of in ltration (n = 31). The pain evaluated by NRS was signi cantly lower in ropivacaine group at H4 (1,9 ± 0,3 versus 3,6 ± 0,5, p = 0,006), H8 (3,3 ± 0,4 versus 5,2 ± 0,4, p = 0,003), H12 (2,8 ± 0,4 versus 5,2 ± 0,4,p = 0,0001) and H24 (2,6 ± 0,4 versus 4,3 ± 0,4, p = 0,006).…”

Section: Introductionmentioning

confidence: 99%

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Ropivacaine 75mg versus placebo in perineal infiltration for analgesic efficacy at mid- and long-term for episiotomy repair in postpartum women- The ROPISIO study: a two-center, randomized, double-blind, placebo-controlled trial.

Cardaillac

Ploteau

Thuaut

et al. 2020

Preprint

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Background Perineal pain due to episiotomy is commonly reported and can be severe enough to disturb the mother-infant dyad during the postpartum period. Its incidence at day 7 postpartum varies from 63% to 74%. Recent studies have already investigated the analgesic efficacy of perineal infiltration of ropivacaine after episiotomy, but have only focused on the immediate postpartum period (at 24 and 48 hours after birth). Large, adequately powered, multicenter, randomized controlled trials are required to evaluate the impact of ropivacaine infiltration on perineal pain and mid- and long-term quality of life before the widespread use of ropivacaine to prevent perineal pain after episiotomy can be recommended. Methods The ROPISIO study is a two-center, randomized, double-blind, placebo-controlled trial in La Roche sur Yon and Nantes, France. It will involve 272 women with vaginal singleton delivery and mediolateral episiotomy at term (≥ 37 weeks). Perineal infiltration (ropivacaine 75mg or placebo) will be administrated just after vaginal birth and before episiotomy repair. The primary outcome will be the analgesic efficacy at day 7 postpartum (mid-term), defined by the numerical rating scale of pain (ENS NRS) strictly superior to 3/10 on the perineal repair area. Secondary outcomes will be the analgesic efficacy (ENS NRS), the impact of pain on daily behavior, on the quality of life (36-Item Short Form Health Survey), on the occurrence of symptoms of postpartum depression (Edinburgh Postnatal Depression Scale) and on sexuality (Female Sexual Function Index) at 3 and 6 months (long-term) using validated online questionnaires. This study will have 90% power to show approximately 30% relative risk reduction in the incidence of perineal pain at day 7, from 70.0% to 50.0%. Discussion Ropivacaine is a promising candidate drug, inexpensive, easy to administer, and would be suitable to include in the routine management of deliveries in labor ward. This study will investigate if perineal ropivacaine infiltration just after birth can reduce mid- and long-term postpartum pain and increase quality of life in women with mediolateral episiotomy.

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