Comparison of the effects of lidocaine-prilocaine cream (XYLA cream) and lidocaine injection on reduction of perineal pain while doing and repairing episiotomy in natural vaginal delivery

Background and Objectives: Doing and repairing episiotomy in natural vaginal delivery is a painful phenomenon and various methods have been used to reduce its pain. Nowadays, topical ointments are being increasingly used due to low systemic absorption and ease of use. The present study aimed to compare the effects of XYLA cream and lidocaine injection on reduction of pain while doing and repairing episiotomy Methods: This randomized clinical trial was conducted on 98 pregnant women with the gestational age of > 37 weeks. In the intervention group that contained 50 women, 5 gr XYLA cream was applied to the episiotomy area one hour prior to delivery. It was also applied to healthy wound edges to numb the area while repairing episiotomy. In the control group, lidocaine 2% injection was used at the time of delivery. The two groups were compared regarding demographic characteristics, delivery characteristics, pain intensity based on Visual Analogue Scale (VAS), and satisfaction with the applied technique Results: The results showed no significant differences between the two groups regarding age, occupation, mother’s weight and education level, gestational age, parity, number of deliveries, and infant’s weight and head circumference (p> 0.05). Also, no significant difference was found between the two groups concerning the length of the active, second, and third phases of labor (p> 0.05). Considering postpartum complications (episiotomy wound infection), infection was detected in three participants in the XYLA cream group and four ones in the lidocaine group, but the difference was not statistically significant (p=0.376). It should be noted that application of XYLA cream did not cause eye irritation in any of the infants. The results also revealed no significant differences between the two groups with respect to pain intensity and satisfaction with the applied technique after doing and repairing episiotomy (p=0.288).Conclusion: The results indicated that XYLA cream had no specific complications and had a similar effect to lidocaine injection while doing episiotomy

Keywords:

Episiotomy , Pain intensity , Lidocaine , XYLA cream (lidocaine-prilocaine