• Christophe Gutton, Jean-Pierre Bellefleur, Séverine Puppo, Julie Brunet, Francois Antonini, Marc Leone, and Florence Bretelle.
• Department of Anesthesia and Reanimation, APHM Hôpital Nord, Marseille, France.
• Int J Gynaecol Obstet. 2013 Jul 1; 122 (1): 33-6.

ObjectiveTo evaluate maternal analgesia after an episiotomy during delivery.MethodsThe present case-control study compared 2 protocols of post-episiotomy infiltration: period A, 20 mL of lidocaine 10mg/mL; period B, 20 mL of ropivacaine 7.5mg/mL. The primary study endpoint was the visual analog scale (VAS) score at 24 hours after episiotomy; secondary endpoints were the VAS scores during suturing and at 2 and 48 hours, and patient satisfaction at 48 hours.ResultsIn total, 102 women were included in the study. The median VAS score at 24 hours was significantly lower during the ropivacaine period (3 [1.5-4]) than during the lidocaine period (4 [2-6]; P=0.004). A VAS score below 4 at 24 hours was significantly more frequent with ropivacaine (71% versus 43%; P=0.009). The VAS scores at 2 and 48 hours were also lower in the ropivacaine group (2 hours, 0 [0-1] versus 1 [0-3], P=0.01; and 48 hours, 2 [0-3] versus 3 [2-5], P<0.001). Maternal satisfaction was significantly higher in the ropivacaine group.ConclusionAnalgesia and maternal satisfaction were improved during the period when ropivacaine was used as opposed to lidocaine. The effect lasted for up to 48 hours.Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

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