Efficacy and safety of post-cesarean section incisional infiltration with lidocaine and epinephrine versus lidocaine alone in reducing postoperative pain: A randomized controlled double-blinded clinical trial

Tharwat, Alaa; Yehia, Ahmed; Wahba, Karim; Ali, Abd-Elrhman G.

doi:10.5152/jtgga.2015.0185

Cited by 9 publications

(10 citation statements)

References 16 publications

(16 reference statements)

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“…158 Risk for surgical site infection is not increased, but these studies have not been powered for this outcome. 159 Continuous wound infusion is less effective than parenteral morphine and NSAIDs. 158 Most trials have not included neuraxial morphine comparisons, so no definitive comments can be made about superiority to neuraxial morphine.…”

Section: Anesthesia For Cesarean Deliverymentioning

confidence: 99%

A Review of the Impact of Obstetric Anesthesia on Maternal and Neonatal Outcomes

et al. 2018

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Obstetric anesthesia has evolved over the course of its history to encompass comprehensive aspects of maternal care, ranging from cesarean delivery anesthesia and labor analgesia to maternal resuscitation and patient safety. Anesthesiologists are concerned with maternal and neonatal outcomes, and with preventing and managing complications that may present during childbirth. The current review will focus on recent advances in obstetric anesthesia, including labor anesthesia and analgesia, cesarean delivery anesthesia and analgesia, the effects of maternal anesthesia on breastfeeding and fever, and maternal safety. The impact of these advances on maternal and neonatal outcomes is discussed. Past and future progress in this field will continue to have significant implications on the health of women and children.

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Section: Anesthesia For Cesarean Deliverymentioning

confidence: 99%

A Review of the Impact of Obstetric Anesthesia on Maternal and Neonatal Outcomes

et al. 2018

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“…In parallel with our study, Tharwat et al ( 20 ) assessed the efficacy and safety of incisional infiltration of local lidocaine in patients undergoing CD. They demonstrated that lidocaine administration reduced the opioid analgesic dose postoperatively and enhanced patient recovery.…”

Section: Discussionmentioning

confidence: 71%

Comparison of bilateral transversus abdominis plane block and wound infiltration with bupivacaine for postoperative analgesia after cesarean delivery

Görkem¹,

Koçyiğit²,

Toğrul³

et al. 2017

J Turkish German Gynecol AssocJ Turkish German Gynecol Assoc

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Objective:The study aimed to compare efficacy, safety, pain intensity and analgesic consumption in patients receiving either bilateral transversus abdominis plane (TAP) block or wound infiltration with bupivacaine after cesarean delivery (CD).Material and Methods:A total of 216 parturient women undergoing CD under general anesthesia were randomly allocated into five groups: i) controls (group 1), ii) TAP placebo (group 2), iii) TAP (group 3), iv) wound infiltration placebo (group 4), and, v) wound infiltration (group 5). Pain intensity was assessed using a visual analogue scale (VAS). Analgesic consumptions were recorded by a blinded nurse at 6, 12, and 18 hours postoperatively.Results:The baseline characteristics of the five groups were similar in terms of age, history of CD, and body mass indices (p>0.05). There were significant intergroup differences in VAS scores between all groups at the zero time-point (p=0.03), at the 6th hour (p=0.02), 12th hour (p=0.02), and at the 18th hour (p=0.02). Group 3 patients had lower pain scores and consumed less diclofenac than group 2 patients only within 12 hours postoperatively whereas pain intensity and analgesic consumption were not different between group 5 and group 4 patients. Group 5 patients received significantly less pethidine than group 4 and group 1 patients (p<0.001).Conclusion:TAP block provided better pain relief and less analgesic requirement than bupivacaine wound infiltration early after CD. Given the similar amounts of diclofenac but lower amounts of pethidine administered in the wound infiltration group, wound infiltration of bupivacaine seems promising in terms of reducing opioid use after CD under general anesthesia, especially when TAP block is not used.

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“…3% chloroprocaine with epinephrine compared to 2%lidocaine with epinephrine showed [46] a long duration and best surgical analgesia with lidocaine2% and epinephrine. Through these findings, we deduce that lidocaine 2% is a best choice for epidural elective CD, all the more so, if epinephrine was added on it [4] . The advantages of using lidocaine in EPA for CD include his quick anesthesia onset, thereby avoiding GA and threaten side effectsassociated, when occurring.…”

Section: Discussionmentioning

confidence: 80%

“…Recent researches showed that more than 32% [35% in USA [1] ;32,5 in Ethiopia, Africa [2] , 32% in Thailand [3] of women, give birth under cesarean section [CS]. The trend is increasing [1] and even reached 46% in China according to the results of a study published in 2016 [4] . Many cesarean deliveries [CD] are performed under neuraxial anesthesia using local anesthetics [LAs] [2] .…”

Section: Introductionmentioning

confidence: 99%

Incidence of Hypotension and Associated-risk Factors in Epidural Anesthesia With 2% Lidocaine and Epinephrine During Elective Cesarean Section, Efficacy and Safety Assessment

2021

GJACR

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Background: Cesarean section is a worldwide common surgery that requires anesthetic techniques. Many local anesthetics are being now used, but are associated with, dose- dependent and at different level, some side effects including toxicity. Hypotension was described as the first and threat side effect associated to neuraxial techniques. Despite many preventive strategies, it continues to challenge anesthesia providers around the world. Lidocaine was found to be less toxic compared with others commonly used and has been recommended for anesthesia procedures requiring large dose of local anesthetic including epidural anesthesia. The main purpose of this research was to determine the incidence of hypotension and identify the possible risk factors associated with it and thus, assess the efficacy and safety when lidocaine is applied together with epinephrine, in epidural anesthesia for elective cesarean delivery. Materials and methods: This retrospective observational institutional-based study, recruited 612 parturients who underwent elective cesarean section under epidural anesthesia with 2% lidocaine and 1/200000 epinephrine, at 1st affiliated hospital of Chongqing Medical University in 2019. Exclusion criteria included any contraindication to elective cesarean section delivery, general anesthesia, baseline systolic blood pressure < 100mmh and > 140 mm hg, gestational age < 37 weeks and > 42 weeks etc. SPSS 26.0 version and different appropriated tests were used for statistical analysis. P value < 0.05 was accepted as statistically significant. Results: The hypotension incidence was 13.2%, and identified factors associated with it were Baseline Systolic Blood Pressure < 120mmhg, gestational age < 40 weeks, maternal body weight ≤ 60 kg and duration of cesarean delivery (surgery) > 45 minutes. Conclusion: The variables in correlation with increased hypotension rate are baseline systolic blood pressure, gestational age, maternal weight, and surgery duration. 2%Lidocaine with epinephrine as adjuvant presented best outcomes towards both mother and neonates, was therefore efficacy and safe under the anesthetic conditions of our study.

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Efficacy and safety of post-cesarean section incisional infiltration with lidocaine and epinephrine versus lidocaine alone in reducing postoperative pain: A randomized controlled double-blinded clinical trial

Abstract: Administering epinephrine with 2% lidocaine prolongs the anesthetic effect and reduces the opioid analgesic dose postoperatively required, thereby enhancing patient recovery.

Cited by 9 publications

References 16 publications

A Review of the Impact of Obstetric Anesthesia on Maternal and Neonatal Outcomes

A Review of the Impact of Obstetric Anesthesia on Maternal and Neonatal Outcomes

Comparison of bilateral transversus abdominis plane block and wound infiltration with bupivacaine for postoperative analgesia after cesarean delivery

Incidence of Hypotension and Associated-risk Factors in Epidural Anesthesia With 2% Lidocaine and Epinephrine During Elective Cesarean Section, Efficacy and Safety Assessment

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