ORDA - Online Research Data Archive 
    • Login
    View Item 
    •   ORDA Home
    • University Hospitals of Derby and Burton NHS Foundation Trust
    • Division of Women's and Children's Services
    • Gynaecology
    • View Item
    •   ORDA Home
    • University Hospitals of Derby and Burton NHS Foundation Trust
    • Division of Women's and Children's Services
    • Gynaecology
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Lidocaine-prilocaine cream versus local infiltration anaesthesia in pain relief during repair of perineal trauma after vaginal delivery: a systematic review and meta-analysis.

    Thumbnail
    Abstract
    BACKGROUND: Perineal trauma is a common problem that may affect women during vaginal delivery; this trauma can either spontaneous (tear) or intentional (episiotomy). When repair of perineal trauma is required, adequate analgesics must be obtained. Topical products as lidocaine-prilocaine (EMLA) cream is one of the suggested methods, but still there is lack of evidence with regard to its efficacy and safety. OBJECTIVE: The aim of this review is to assess the evidence of utilizing EMLA cream in comparison to local perineal infiltration anaesthesia for pain control during perineal repair after vaginal delivery. DATA SOURCES: Medline, Embase, Dynamed Plus, ScienceDirect, TRIP database, ClinicalTrials.gov and the Cochrane Library were searched electronically from January 2006 to May 2018 for studies investigating the effect of lidocaine-prilocaine cream in relieving pain during repair of perineal trauma. METHODS OF STUDY SELECTION: All randomized controlled trials assessing effect of lidocaine-prilocaine cream versus local infiltration anaesthesia in relieving pain during repair of perineal trauma were considered for this meta-analysis. Fifteen studies were identified of which four studies deemed eligible for this review. Quality and risk of bias assessment was performed for all studies. DATA EXTRACTION: Two researchers independently extracted the data from the individual articles and entered into RevMan software. The weighted mean difference (WMD) and 95% confidence interval (CI) was calculated. Statistical heterogeneity between studies was assessed by the Higgins chi-square and (I2) statistics. When heterogeneity was significant, a random-effects model was used for meta-analysis. Otherwise, fixed effect meta-analysis was used when there was no significant heterogeneity. RESULTS: Pooled analysis of result in "pain score" was insignificant between the two groups (WMD -1.11; 95% CI (-2.55 to 0.33); p = 0.13). Furthermore, the use of additional analgesia showed no statistically significant difference between the two groups (WMD 1.34; 95% CI (0.66-2.71), p = 0.42). Regarding patient satisfaction, overall analysis of three studies showed significant results favouring EMLA cream group users (WMD 4.65; 95% CI (1.96-11.03), p = 0.0005). The pooled analysis of the outcome "duration of repair" showed significantly shorter duration of repair in EMLA cream users (n = 92) than local infiltration anaesthesia (n = 95) (1.72 min; 95% CI (-2.76 to -0.67), p = 0.001). CONCLUSIONS: This meta-analysis suggests that topical lidocaine-prilocaine cream gives comparable results in reducing pain during perineal repair after vaginal delivery.
    URI
    https://orda.derbyhospitals.nhs.uk/handle/123456789/1634
    Collections
    • Gynaecology [49]
    Date
    2018-08
    Author
    El-Shamy, Tarek
    James, Cathryn
    Show full item record

    copyright © 2017  Derby Teaching Hospitals NHS Foundation Trust
    Contact Us | Send Feedback
    Powered by KnowledgeArc
     

     

    Browse

    All of ORDACommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects

    Researcher Profiles

    Researchers

    My Account

    Login

    copyright © 2017  Derby Teaching Hospitals NHS Foundation Trust
    Contact Us | Send Feedback
    Powered by KnowledgeArc