الفهرس | Only 14 pages are availabe for public view |
Abstract To compare the efficacy of topically applied lidocaine-prilocaine (EMLA) cream with local anesthetic (lidocaine) infiltration on post-cesarean section pain. Patients and methods: A prospective randomized controlled trial was designed to compare the efficacy of topically applied 10 gm lidocaine-prilocaine (EMLA) cream with local anesthetic (20 ml 1 % lidocaine) infiltration on post-cesarean section pain. There was eighty full term pregnant women randomized into two groups: - Group A (40 patients) -----> EMLA group. - Group B (40 patients) -----> lidocaine group. All patients had C.S under spinal anesthesia and received post – operative analgesia (pethidine) according to visual analogue scale value. The total amount of pethidine used was assessed at 30 minutes, 2, 4, 6, 8, 12 and 24 hours. Frist time request analgesia and time onset of breast feeding and ambulation were assessed. Results: The topical application of lidocaine-prilocaine (EMLA) cream to the surgical wound of cesarean section after spinal anesthesia, provides effective analgesia comparable to infiltration with 1% lidocaine for several hours, decreases systemic opioid consumption, decreases patients ambulation time and prolongs first time request analgesia. Conclusion: We concluded that topical application of lidocaine-prilocaine (EMLA) cream to the surgical wound of cesarean section after its closure, after bupivacaine spinal anesthesia, provides effective analgesia comparable to infiltration with 1% lidocaine for several hours, decreases systemic opioid consumption, decreases patients ambulation time and prolongs first time request analgesia. This protocol could be applied by all members of obstetrical team for all C.S under spinal anesthesia Recommendation: We recommend applying topical lidocaine-prilocaine (EMLA) as analgesic for cesarean section wound as it reduces consumption of analgesics post – operative. So, it provides less side effects of analgesics and provides earlier ambulation. |