Pain relief effects of ropivacaine for perineal pain during vaginal delivery under epidural labor analgesia: a double-blind randomized controlled trial

Abstract

Objectives To compare the effects of ropivacaine versus lidocaine infiltration on the pain relief for perineal pain of puerpera undergoing vaginal delivery. Methods This is a prospective, randomized, double-blind study. Seventy-four puerperae with term singleton fetus undergoing vaginal delivery under epidural labor analgesia were enrolled into this study in the maternity center of our hospital from February 2016 to April 2017. Among them, 60 were primipara and 14 were transpartum women. They were randomly allocated into ropivacaine group and lidocaine group (n=37). Before planned episiotomy or perineal repair, 0.75 % ropivacaine or 1 % lidocaine infiltration was injected to them. Visual analog scale (VAS) was used to rank the perineal pain grade. Moreoven, the puerpera's satisfaction was evaluated. Results There were more puerpera with VAS score equal to 0 in the ropicavaine group than the lidocaine group at 1 min (33 vs 26, P=0.043) after injection, and 3 (31 vs 20, P=0.006), 4 (27 vs 11, P < 0.001) and 6 h (20 vs 0, P=0.030) after delivery. The proportion of puerpera with VAS score of 0 in ropivacaine group was larger than that in the lidocaine group when they were sitting up (11 vs 0, P < 0.001), urinating (22 vs 3, P < 0.001) and sleeping (32 vs 24, P=0.030) after delivery. Maternal satisfaction (very satisfied or satisfied) with labor analgesia in the ropivacaine group was better than that in the lidocaine group (36 vs 29, P=0.013). There were no significant differences in Apgar score, umbilical artery and venous pH value, BE, lactic acid content, partial pressure of carbon dioxide and hemoglobin content between the 2 groups. Conclusion Ropivacaine perineal infiltration can provide faster and longer analgesia than lidocaine. It can significantly improve the satisfaction of vaginal delivery women with epidural labor analgesia.

Keywords

• opivacaine
• lidocaine
• anesthesia local
• natural childbirth
• analgesia obstetrical