Comparison between lidocaine-prilocaine cream (EMLA) and mepivacaine infiltration for pain relief during perineal repair after childbirth: a randomized trial

Am J Obstet Gynecol. 2009 Aug;201(2):186.e1-5. doi: 10.1016/j.ajog.2009.04.023. Epub 2009 Jun 26.

Abstract

Objective: The purpose of this study was to compare the effectiveness of topically applied lidocaine-prilocaine (EMLA) cream with local anesthetic infiltration in the reduction of pain during perineal suturing after childbirth.

Study design: Sixty-one women with either an episiotomy or a perineal laceration after vaginal delivery were assigned randomly to receive either the application of EMLA cream (n = 31) or infiltration with mepivacaine (n = 30) before perineal suturing. Primary outcome was pain during perineal repair.

Results: Women in the EMLA group had lower pain scores than those in the mepivacaine group (1.7 +/- 2.4 vs 3.9 +/- 2.4; P = .0002). The proportion of women who needed additional anesthesia was similar in the 2 groups (3/30 vs 5/31; P = .71). A significantly higher proportion of women expressed satisfaction with anesthesia method in the EMLA group, compared with the mepivacaine group (83.8% vs 53.3%; P = .01)

Conclusion: EMLA cream appears to be an effective and satisfactory alternative to local anesthetic infiltration for the relief of pain during perineal repair.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Topical
  • Adult
  • Anesthetics, Combined / administration & dosage
  • Anesthetics, Local / administration & dosage*
  • Delivery, Obstetric / adverse effects
  • Episiotomy*
  • Female
  • Humans
  • Lidocaine / administration & dosage*
  • Lidocaine, Prilocaine Drug Combination
  • Mepivacaine / administration & dosage
  • Pain / drug therapy*
  • Parturition*
  • Patient Satisfaction
  • Perineum / injuries*
  • Pregnancy
  • Prilocaine / administration & dosage*
  • Sutures
  • Vaginal Creams, Foams, and Jellies

Substances

  • Anesthetics, Combined
  • Anesthetics, Local
  • Lidocaine, Prilocaine Drug Combination
  • Vaginal Creams, Foams, and Jellies
  • Prilocaine
  • Lidocaine
  • Mepivacaine