A comparative study of tumescent anaesthesia (0.1% lignocaine with adrenaline) versus 2% lignocaine for episiotomy

Abstract

Introduction: Tumescent anaesthesia is a practice of giving a very dilute form of local anaesthesia drug combined with epinephrine to a tissue till the tissue becomes firm and tense (tumescent). Delivery is a physiological procedure associated with great pain, which is in turn added by the episiotomy procedure. Advantage of using tumescent anaesthesia as a local anaesthetic agent include that it reduces the blood loss by both epinephrine induced vasoconstriction and hydrostatic compression from the tumescent effect. Tumescent lignocaine absorbed slowly from subcutaneous tissue that produces lower & more delayed peek serum levels and also extended analgesic effect after procedure. Aim and Objectives: To compare the effects of tumescent anaesthesia over 2% lignocaine for episiotomy in patients delivering via labour natural in Rajah Muthiah Medical College and Hospital, Chidambaram. To study the effectiveness of tumescent anaesthesia in decreasing blood loss at episiotomy site. To study the effectiveness of tumescent anaesthesia in reducing pain and prolonging the analgesic effect. To study the effectiveness of tumescent anaesthesia aiding in demarcation of layers of episiotomy wound while repairing. Materials and Methods:To the patients who progress for vaginal delivery in stage two of labour before crowning of fetal head 10 ml of 2% lignocaine and 10 ml of tumescent anaesthesia [0.1% lignocaine with adrenaline) to be instilled into the perineal skin at the episiotomy site left mediolateral (By randomised selection of patients). When fetal head crowns episiotomy to be given and baby to be delivered. After removal of the placenta, episiotomy wound will be sutured in layers. Results:The mean Duration of analgesia in Group A was 93.467 ± 17.4529 & group B was 198.100 ± 12.0669 with P value less than 0.05, which was statistically significant. The mean time of suturing episiotomy n group A was 22.19 ± 1.642 and group B was 12.45 ± 1.947 with P value <0.05, which was statistically significant. Conclusion:The inference of the study shows that tumescent anaesthesia (0.1% lignocaine with adrenaline) has certain benefits when used as local anaesthesia for doing and repairing episiotomy when compared to 2% lignocaine in terms of prolonging duration of analgesia, reducing the time taken to suture episiotomy wound by demarcating the tissues which aids in easy suturing.