Effect of Xylocaine spray for analgesia during amniocentesis: a randomized controlled trial

Abstract

Objective To compare the effect of Xylocaine spray on pain score during amniocentesis Methods Singleton pregnant women undergoing amniocentesis were recruited. Each participant was randomly assigned into three groups. Group 1 (Xylocaine spray): 1 min before the procedure, 8 puffs (80 mg) of 10% Lidocaine spray were sprayed on abdominal wall: group 2 (placebo): 8 puffs of sterile normal saline were sprayed: and group 3 (control): no spray was used. The participants rated their pain through a 10‐cm visual analog scale before, during, and 30 min after amniocentesis. Main outcome of study was difference in pain score among three groups. Results A total 570 pregnant women participated; 191 in the Xylocaine group, 193 in placebo group, and 186 in control group. Baseline pain was not different. The median procedural pain score was significantly different (2.3, 3.3, and 2.8 respectively; p 0.001). Post‐hoc analysis showed that the procedural pain score in Xylocaine group was significantly lower than placebo or control group (p value <0.001 and 0.02, respectively). However, the pain score 30 min after procedure was not different. Conclusion Xylocaine spray can significantly decrease pain during amniocentesis, however, the clinical significance is unclear given that the procedure‐related discomfort is mild and short‐lived.

Efficacy of lidocaine local anesthesia on pain perception during amniocentesis: A meta-analysis of randomized controlled trials

“…Overall, 203 citations were retrieved after the omission of duplicates. Additionally, nine articles progressed to full-text screening, of which five studies met the eligibility criteria and were included in the quantitative synthesis ( Figure 1 ) ( 5 , 6 , 7 , 8 , 9 ) .…”

“…We included five RCTs ( 5 , 6 , 7 , 8 , 9 ) with 1004 patients (lidocaine arm n=502 patients and control arm n=502 patients). Three RCTs used lidocaine as injection ( 5 , 6 , 7 ) and two RCTs used it as non-injection [spray ( 8 ) and cream ( 9 ) ]. Table 1 and Table 2 , respectively, summarize the major features of the included studies and participants.…”

“…Several randomized controlled trials (RCTs) explored the capacity of lidocaine-mediated pain relief among pregnant women undergoing amniocentesis ( 5 , 6 , 7 , 8 , 9 ) . However, the findings of these RCTs were limited by various shortcomings, such as small sample sizes, relatively poor quality of studies, different routes of administration, and inconsistent reported results.…”

Cold therapy for pain relief during and after amniocentesis procedure: A randomized controlled trial

“…While pharmacological therapy can be used for local pain control, a study by Pongrowjpaw et al 4 in 2007 found that lidocaine‐prilocaine cream does not decrease the pain during amniocentesis. Use of xylocaine spray 15 does have some pain‐reducing effect, but only when confined to the skin and mucosal layer. Pain reduction was minimal and had only a short duration.…”

“…Local lidocaine injection can inhibit nerve conduction at the skin area, subcutaneous tissue, peritoneal, and uterus. This procedure maximizes the analgesic effect during amniocentesis, while the local topical analgesia in the previous studies 4,15,17 can affect the nerve conduction only on the skin, mucosa, and subcutaneous tissue. Furthermore, the local application of analgesia is simple and less painful as compared with analgesia injection, and does not have the risks associated with intravenous lidocaine injection and lidocaine hypersensitivity.…”