Ghalenoii Zahra, Movahedi Shohreh, Motezaker Amirabbas, Ebrahimi Elham
Department of Obstetrics and Gynecology, Baharlou Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Nursing and Midwifery Care Research Center, Department of Reproductive Health Midwifery, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Anesth Pain Med. 2025 Jan 12;14(6):e157126. doi: 10.5812/aapm-157126. eCollection 2024 Dec.
One of the fundamental principles of medical interventions is to avoid causing pain to patients, and childbirth is no exception. With the rising prevalence of cesarean sections, addressing factors that may diminish maternal satisfaction is crucial. Spinal anesthesia, the most common method for cesarean sections, faces challenges such as patient anxiety. To mitigate pain associated with needle insertion, various methods, including lidocaine spray and Xyla-P cream, have been recommended.
This study aimed to evaluate the effectiveness of lidocaine spray and Xyla-P cream in reducing pain during needle insertion for spinal anesthesia in cesarean sections.
This randomized, placebo-controlled interventional study included 263 pregnant women at 37 weeks or more of gestational age who were candidates for elective cesarean sections. Participants were randomly assigned to intervention and control groups using a block permutation technique. In intervention group 1, 10 g of Xyla-P cream was applied 30 minutes before spinal anesthesia. In intervention group 2, three puffs of 10% lidocaine spray were used. The control group received three puffs of water spray ten minutes before anesthesia. Pain intensity and anxiety were assessed using the Visual Analog Scale (VAS), and maternal cooperation was scored by the anesthesiologist.
The mean age of the participants was 30 years, and 21% had no prior history of cesarean section. There was no significant difference in pain, anxiety, satisfaction, and cooperation between the Xyla-P and lidocaine groups. However, in the group receiving lidocaine, satisfaction (P-value: 0.001) and cooperation (P-value: 0.019) improved significantly compared to the placebo group, whereas anxiety increased significantly compared to the placebo group (P-value: 0.045).
Lidocaine had a positive effect on maternal satisfaction with spinal anesthesia and, compared to the placebo, led to significant improvements in maternal satisfaction and cooperation. In light of these findings, lidocaine emerges as a more appropriate choice than Xyla-P cream.
医疗干预的基本原则之一是避免给患者带来痛苦，分娩也不例外。随着剖宫产率的上升，解决可能降低产妇满意度的因素至关重要。脊髓麻醉是剖宫产最常用的方法，面临着患者焦虑等挑战。为减轻与穿刺相关的疼痛，已推荐了多种方法，包括利多卡因喷雾和昔拉普乳膏。
本研究旨在评估利多卡因喷雾和昔拉普乳膏在减轻剖宫产脊髓麻醉穿刺时疼痛方面的有效性。
这项随机、安慰剂对照的干预性研究纳入了263名孕周37周及以上、计划行择期剖宫产的孕妇。采用区组随机化技术将参与者随机分为干预组和对照组。干预组1在脊髓麻醉前30分钟涂抹10克昔拉普乳膏。干预组2使用3喷10%利多卡因喷雾。对照组在麻醉前10分钟使用3喷水喷雾。使用视觉模拟量表（VAS）评估疼痛强度和焦虑程度，并由麻醉医生对产妇的配合度进行评分。
参与者的平均年龄为30岁，21%既往无剖宫产史。昔拉普组和利多卡因组在疼痛、焦虑、满意度和配合度方面无显著差异。然而，与安慰剂组相比，接受利多卡因的组满意度（P值：0.001）和配合度（P值：0.019）显著提高，而焦虑程度与安慰剂组相比显著增加（P值：0.045）。
利多卡因对产妇对脊髓麻醉的满意度有积极影响，与安慰剂相比，显著提高了产妇的满意度和配合度。鉴于这些发现，利多卡因比昔拉普乳膏更合适。
