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Topic anaesthesia with a eutectic mixture of lidocaine/prilocaine cream after elective caesarean section: a randomised, placebo-controlled trial

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Aim of the study was to investigate the topical application of a eutectic mixture of lidocaine/prilocaine (EMLA®) cream after caesarean section (CS) and its effect on postoperative pain, time to mobilisation, and time to discharge.

Materials and methods

A total of 189 pregnant women were enrolled; full data sets were available for 139 of them, who were prospectively randomised to receive either placebo (control group) or EMLA® cream (study group) on the CS lesion directly as well as 24 h after surgery. Postoperative pain was assessed 24 and 48 h after surgery using the short form of the McGill Pain Questionnaire (SF-MPQ). Additional analgesic pain medication on demand was assessed in both groups.

Results

A total of 62 women were allocated randomly to the study and 77 patients to the control group before primary CS. There were no statistically significant differences regarding demographic and surgical parameters comparing both collectives. In addition, the postoperative total pain scores after 24 h [McGill total: 38.5 (0–102) vs. 50 (0–120) p = 0.0889] as well as after 48 h [24 (0–79) vs. 30.5 (0–92); p = 0.1455] showed no significant differences. Furthermore, time to mobilisation (hours) [9.68 (2.18–51.38) vs. 9.47 (4.18–41.77); p = 0.5919] and time to discharge (hours) [98.6 (54.08–170.15) vs. 98.2 (43.45–195.87); p = 0.5331] were comparable.

Conclusion

The postoperative application of EMLA® cream after CS did not reduce postoperative pain or time to mobilisation or discharge, so that its use in this context has to be seen critically.

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Author notes

  1. Thomas Grosse-Steffen and Malin Krämer have contributed equally.

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Thomas Grosse-Steffen, Malin Krämer, Benjamin Tuschy, Marc Sütterlin & Sebastian Berlit

  2. Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Christel Weiss

Authors
  1. Thomas Grosse-Steffen
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  2. Malin Krämer
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  3. Benjamin Tuschy
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  4. Christel Weiss
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  5. Marc Sütterlin
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  6. Sebastian Berlit
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Contributions

TG-S: project development and manuscript writing. MK: data collection and management; BT: manuscript writing/editing; CW: statistical analysis; MS: funding the project and manuscript editing. SB: project development, supervision, and manuscript writing

Corresponding author

Correspondence to Thomas Grosse-Steffen.

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Funding

This study was funded by the Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University.

Conflict of interest

The authors declare that they do not have any conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Grosse-Steffen, T., Krämer, M., Tuschy, B. et al. Topic anaesthesia with a eutectic mixture of lidocaine/prilocaine cream after elective caesarean section: a randomised, placebo-controlled trial. Arch Gynecol Obstet 296, 771–776 (2017). https://doi.org/10.1007/s00404-017-4486-6

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  • DOI: https://doi.org/10.1007/s00404-017-4486-6

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