利多卡因-丙胺卡因乳膏与利多卡因注射剂对自然阴道分娩时会阴切开及修补术中会阴疼痛减轻效果的比较：随机临床试验
Comparison of the Effects of Lidocaine-Prilocaine Cream and Lidocaine Injection on the Reduction of Perineal Pain While Doing and Repairing Episiotomy in Natural Vaginal Delivery: Randomized Clinical Trial.
作者信息
Moradi Zahra, Kokabi Roya, Ahrari Fatemeh
机构信息
Nursing School, Fasa University of Medical Sciences, Fasa, Iran.
Obstetric and Gynecology Department, Fasa University of Medical Sciences, Fasa, Iran.
出版信息
Anesth Pain Med. 2019 Apr 24;9(3):e90207. doi: 10.5812/aapm.90207. eCollection 2019 Jun.
BACKGROUND
Doing and repairing episiotomy in a natural vaginal delivery is a painful phenomenon and various methods have been used to reduce its pain. Nowadays, topical ointments are being increasingly used due to low systemic absorption and ease of use.
OBJECTIVES
The present study aimed to compare the effects of lidocaine-prilocaine cream (XYLA cream) and lidocaine injection on the reduction of pain while doing and repairing episiotomy.
METHODS
This randomized clinical trial was conducted on 98 pregnant women with the gestational age of > 37 weeks. In the intervention group that contained 50 women, 5 gr XYLA cream was applied to the episiotomy area one hour prior to delivery. It was also applied to healthy wound edges to numb the area while repairing episiotomy. In the control group, lidocaine 2% injection was used at the time of delivery. The two groups were compared regarding demographic characteristics, delivery characteristics, pain intensity based on visual analogue scale (VAS), and satisfaction with the applied technique.
RESULTS
The results showed no significant differences between the two groups with respect to age, occupation, mother's weight and education level, gestational age, parity, number of deliveries, and infant's weight and head circumference (P > 0.05). Also, no significant difference was found between the two groups concerning the length of the active, second, and third phases of labor (P > 0.05). Considering postpartum complications (episiotomy wound infection), the infection was detected in three participants in the XYLA cream group and four individuals in the lidocaine group, but the difference was not statistically significant (P = 0.376). It should be noted that the application of XYLA cream did not cause eye irritation in any of the infants. The results also revealed no significant differences between the two groups regarding pain intensity and satisfaction with the applied technique after doing and repairing episiotomy (P = 0.288).
CONCLUSIONS
The results indicated that XYLA cream had no specific complications and had an effect similar to lidocaine injection while doing the episiotomy.
背景
在自然阴道分娩时进行会阴切开术及修复是一种痛苦的现象，人们已采用各种方法来减轻其疼痛。如今，由于全身吸收少且使用方便，外用软膏正越来越多地被使用。
目的
本研究旨在比较复方利多卡因乳膏（XYLA乳膏）和利多卡因注射在会阴切开术及修复时减轻疼痛的效果。
方法
本随机临床试验对98名孕周>37周的孕妇进行。干预组有50名女性，在分娩前1小时将5克XYLA乳膏涂抹于会阴切开术区域。在修复会阴切开术时，也将其涂抹于健康的伤口边缘以使该区域麻木。对照组在分娩时使用2%利多卡因注射液。比较两组的人口统计学特征、分娩特征、基于视觉模拟量表（VAS）的疼痛强度以及对所用技术的满意度。
结果
结果显示，两组在年龄、职业、母亲体重和教育水平、孕周、产次、分娩次数以及婴儿体重和头围方面无显著差异（P>0.05）。此外，两组在产程活跃期、第二产程和第三产程的时长方面也无显著差异（P>0.05）。考虑产后并发症（会阴切开术伤口感染），XYLA乳膏组有3名参与者和利多卡因组有4名个体检测到感染，但差异无统计学意义（P=0.376）。应当指出，XYLA乳膏的应用在任何婴儿中均未引起眼部刺激。结果还显示，两组在会阴切开术及修复后的疼痛强度和对所用技术的满意度方面无显著差异（P=0.288）。
结论
结果表明，XYLA乳膏无特定并发症，在进行会阴切开术时其效果与利多卡因注射相似。
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