Lignocaine versus ropivacaine infiltration for postpartum perineal pain

Abstract

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.

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

“…Gutton et al described a significantly greater analgesic effect of ropivacaine than lidocaine 2, 24, and 48 hours after repair under the same technique of local anesthesia [13]. Deshpande and Saundattikar found similar results 2 and 4 hours after repair [29].Schinkel et al performed a local infiltration and did not find significant difference between both local anesthetics during the first 24 hours [30].…”

Ropivacaine perineal infiltration for postpartum pain management in episiotomy repair: a double‐blind, randomised, placebo‐controlled trial

“…Similarly, local injection of bupivacaine has induced a reduction of pain intensity until the 10th day after tonsillectomy 18,19 20‐23 . Three of these highlighted the significant benefit of ropivacaine, compared with no infiltration 21 or administration of another anaesthetic agent 20,22 .…”

“…18,19 Four studies have already compared the analgesic efficacy of local infiltration post-episiotomy. [20][21][22][23] Three of these highlighted the significant benefit of ropivacaine, compared with no infiltration 21 or administration of another anaesthetic agent. 20,22 Both theoretical arguments and results from previous studies show that ropivacaine is promising in terms of perineal pain prevention.…”

“…[20][21][22][23] Three of these highlighted the significant benefit of ropivacaine, compared with no infiltration 21 or administration of another anaesthetic agent. 20,22 Both theoretical arguments and results from previous studies show that ropivacaine is promising in terms of perineal pain prevention. Nevertheless, not enough studies have been properly conducted to reach any definitive conclusion.…”

Blunting Stress Response During Intubation in Hypertensive Patients; A Comparison Between Lidocaine and Magnesium Sulphate

“…Lignocaine infusion is also used for postoperative and chronic pain relief. 8 Lidocaine, when used intravenously, has antagonistic action on sodium channels and N-methyl-d-aspartate (NMDA) receptors, reduces the release of substance P8 and has glycinergic action, which decreases the airway reactivity. 9 The rationale of this study was to compare the blunting of stress response to intubation with…”