Topical lidocaine-prilocaine cream versus rectal meloxicam suppository for relief of post-episiotomy pain in primigravidae: A randomized clinical trial

Objectives: To compare the analgesic effect of topical lidocaine-prilocaine (LP) cream and rectal meloxicam suppository on the post-episiotomy pain in primigravidae. Patients and methods: A randomized open-label clinical trial included primigravidae delivered vaginally with episiotomy. Eligible women were recruited and randomized to topical LP cream on the episiotomy line or rectal meloxicam suppository 15 mg. The intensity of the perineal pain was assessed using a visual analog scale (VAS) immediately, at 6, 12 h and after 5 days post-episiotomy. Results: One hundred ninety women were enrolled (n =95 in each arm). No difference between both groups in the VAS scores immediately (mean +/- SD: 8.54 +/- 1.35 vs. 8.33 +/- 1.50, p=0.419) and 6h after episiotomy (p = 0.859). However, women in the LP arm were more likely to report lower VAS scores at 12h and 5 days post-episiotomy (mean +/- SD: 120 +/- 0.50 vs. 5.65 +/- 1.65. p =0.0001; 1.19 +/- 0.49 vs. 2.64 +/- 1.73, p <0.001; respectively). Conclusion: Application of topical LP cream after repair of episiotomy in primigravidae seems to substantially alleviate the induced pain with subsequent less need for additional analgesia and more patients' satisfaction. (C) 2020 Elsevier Masson SAS. All rights reserved.