Razi Journal of Medical Sciences

Background: Nowadays some local combinations such as lidocaine prilocaine cream (EMLA) are used to reduce pain in small surgeries. So the aim of this study was to compare the efficacy of EMLA cream and lidocaine injection to reduce pain during episiotomy repair.

Methods: This randomized clinical trial was conducted on 46 primiparous women with normal pregnancy and gestational age of more than 37 weeks, who referred for normal vaginal delivery. They randomly divided into two groups. In one group, 5 g of EMLA cream was applied to perineal mediolateral incision before and after delivery for episiotomy incision and for its repair. Lidocaine 2% was used in another group, too. The two groups were compared in terms of the characteristics of patients, the pain during repairing based on the Visual Analogue Scale (VAS) and satisfaction with repairing method.

Results: The mean (SD) duration of episiotomy repair and pain during repairing was 26±10 and 4.2±2.3 cm, respectively and only 8 people (19%) were in need of further analgesia. Forty women (97%) were partially or fully satisfied with their episiotomy repair. No infection was found at the episiotomy site. Comparing the two groups of EMLA and lidocaine, there was no difference between the two groups in terms of the demographic characteristics, labor characteristics, duration of episiotomy repair, need for further analgesia, pain on the VAS and satisfaction with the repair method.

Conclusion: The use of EMLA cream at the site of episiotomy incision in primiparous women with normal vaginal delivery can induce a level of analgesia equal to that of lidocaine.