Sanders Julia, Campbell Rona, Peters Tim J
Department of Social Medicine, University of Bristol, Bristol BS8 2PR.
BMJ. 2006 Jul 15;333(7559):117. doi: 10.1136/bmj.38878.833241.7C. Epub 2006 Jun 28.
To evaluate the effectiveness and acceptability of a lidocaine spray in reducing perineal pain during spontaneous vaginal delivery.
Randomised controlled trial.
Consultant led obstetric unit.
185 women who had a spontaneous vaginal delivery without epidural analgesia.
Topically applied local anaesthetic spray (93 women) and placebo spray (92 women).
Primary outcome measure was pain during delivery (0-100 scale). The 16 secondary outcome measures included second degree perineal trauma during delivery, trauma of the genital tract, and dyspareunia by two months.
Lidocaine spray did not reduce pain during spontaneous vaginal delivery: mean 77 and 72 on a scale of 0-100 in the lidocaine and placebo groups, respectively (difference between means 4.8, 95% confidence interval -1.7 to 11.2). Lidocaine spray may reduce genital tract trauma during delivery, in particular second degree perineal trauma. The intervention was highly acceptable to the women and midwives.
Although lidocaine spray applied to the perineum during spontaneous vaginal delivery did not reduce perineal pain, it was acceptable to both the women and the midwives.
Current controlled trials ISRCTN99732966 [controlled-trials.com].
评估利多卡因喷雾剂在减轻自然阴道分娩时会阴疼痛方面的有效性和可接受性。
随机对照试验。
由顾问主导的产科病房。
185名自然阴道分娩且未使用硬膜外镇痛的女性。
局部应用局部麻醉喷雾剂（93名女性）和安慰剂喷雾剂（92名女性）。
主要结局指标为分娩时的疼痛（0 - 100分制）。16项次要结局指标包括分娩时的二度会阴裂伤、生殖道损伤以及产后两个月性交困难。
利多卡因喷雾剂并未减轻自然阴道分娩时的疼痛：利多卡因组和安慰剂组在0 - 100分制上的平均分分别为77分和72分（均值差4.8，95%置信区间 -1.7至11.2）。利多卡因喷雾剂可能会减少分娩时的生殖道损伤，尤其是二度会阴裂伤。该干预措施受到女性和助产士的高度认可。
尽管在自然阴道分娩时将利多卡因喷雾剂应用于会阴并未减轻会阴疼痛，但女性和助产士都能接受。
Current controlled trials ISRCTN99732966 [controlled-trials.com]
