Effectiveness and acceptability of lidocaine spray in reducing perineal pain during spontaneous vaginal delivery: Randomised controlled trial

Abstract

Objectives: To evaluate the effectiveness and acceptability of a lidocaine spray in reducing perineal pain during spontaneous vaginal delivery. Design: Randomised controlled trial. Setting: Consultant led obstetric unit. Participants: 185 women who had a spontaneous vaginal delivery without epidural analgesia. Interventions: Topically applied local anaesthetic spray (93 women) and placebo spray (92 women). Main outcome measure: Primary outcome measure was pain during delivery (0-100 scale). The 16 secondary outcome measures included second degree perineal trauma during delivery, trauma of the genital tract, and dyspareunia by two months. Results: Lidocaine spray did not reduce pain during spontaneous vaginal delivery: mean 77 and 72 on a scale of 0-100 in the lidocaine and placebo groups, respectively (difference between means 4.8, 95% confidence interval - 1.7 to 11.2). Lidocaine spray may reduce genital tract trauma during delivery, in particular second degree perineal trauma. The intervention was highly acceptable to the women and midwives. Conclusions: Although lidocaine spray applied to the perineum during spontaneous vaginal delivery did not reduce perineal pain, it was acceptable to both the women and the midwives.