671: The effect of preoperative analgesia with local lidocaine infiltration for post cesarean delivery pain management: a prospective double-blind randomized controlled study

To evaluate the impact of local lidocaine incision-site injection in women undergoing cesarean deliveries (CD), on post operative pain and analgesic requirements. In this prospective, double-blinded, placebo-controlled study, women undergoing elective CD during 2009 were randomly assigned to receive either 1% lidocaine solution or 0.9% saline (placebo) to the abdominal incision site prior to the performance of a Funensteil incision. Patients with more than 2 previous CD or longitudinal scar were excluded from the study. Pain intensity was evaluated using a 1 to 10 visual analog scale (VAS) for up to 48 hours after surgery. Patient's analgesic requirements were recorded. Power analysis revealed that a sample size of 75 patients in each group would be required to detect a two-fold difference in pain scores between the groups, with 80% power and an alpha of 0.05. During the study period 155 women were enrolled. After giving an informed consent, 77 received preemptive analgesia with lidocaine, and 76 received placebo. No significant differences were noted between the groups regarding parity, previous CD, maternal age and gestational age. Pain scores or requirements of analgesia did not differ between the groups (Table).Tabled 1Pain scores and analgesic requirements in patients injected in the incision site with lidocaine or placeboLidocaine n=77Placebo n=76P valueVAS 4 hr3.6±1.83.7±1.60.582VAS 8 hr3.4±1.53.6±1.50.414VAS 12 hr3.3±1.72.9±1.50.155VAS 18 hr2.8±1.53±1.30.453VAS 24 hr2.6±12.9±1.30.206Maximum pain in 24 hr5.7±1.35.6±1.20.827VAS 30 hr3.1±1.42.7±1.20.088VAS 36 hr2.8±1.42.6±1.10.368VAS 42 hr2.5±1.12.3±10.193VAS 48 hr2.2±0.92.2±0.90.921Algolysin in 24 hr53.2%56.6%0.999Algolysin in 24-48 hr46.7%50%0.747Diclofenac in 24 hr92.2%93.4%0.999Diclofenac in 24-48 hr36.4%31.6%0.609Meperidine in 24 hr5.1%5.3%0.999 Open table in a new tab Preemptive analgesia using a local incision-site injection with lidocaine does not seem beneficial in reducing post cesarean pain scores and analgesic requirements.