Interventions in the second stage – local anaesthetic spray

Bibliographic reference Study type Evidence level Number of women Women’s characteristics Intervention Comparison Length of follow-up Outcome measures Effect size Source of funding Additional comments
Sanders, Peters & Campbell 2006349RCT1+Intervention group n=93 Control group n=92Women in second stage of labour with no labour complications and without epidural.Lidocaine spray to perineum when birth thought to be imminentApplication of placebo spray1 week PNMain outcome: Pain during birth

Secondary outcomes: Vaginal trauma Neonatal resuscitation Women’s feelings during birth Perineal trauma
Pain during birth (mean (SD):
lidocaine: 76.9 (21.6) vs. placebo 72.1 (22.2), difference between means 4.8 (−1.7 to 11.2), p=0.14.
Adjustmenting for the differences between trial groups: 6.3 (−0.8 to 13.3), p=0.081.
Most secondary outcomes were similar between groups including: vaginal trauma, neonatal resuscitation, feelings during birth, overall rating of birth experience, sutured after birth and perineal pain 1 week after birth.
There was a significantly lower incidence of 2nd degree perineal trauma in the lidocaine group: 28.0% vs. 44.6%, RR 0.63 (95% CI 0.42 to 0.93), p=0.019.
Women in the lidocaine spray group were also less likely to report dyspareunia on resumption of sexual intercourse L 27.1% vs. 52.7%, RR 0.52 (95% CI 0.35 to 0.76), p=0.0004.
Not statedThe authors point out that the large number of secondary analyses undertaken means these differences could be chance findings.

Country: UK

From: Evidence tables

Cover of Intrapartum Care
Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth.
NICE Clinical Guidelines, No. 55.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2007 Sep.
Copyright © 2007, National Collaborating Centre for Women’s and Children’s Health.

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