Nitrous Oxide Versus Lidocaine for Pain Relief During Episiotomy Repair: A Randomized Trial

Since pain management is an important concern in childbirth. This study was designed to evaluate the effects of nitrous oxide in comparison with lidocaine in terms of pain relief, during episiotomy repair in primiparous women.
In this prospective randomized controlled trial, 120 pregnant women were recruited. The intervention group received nitrous oxide 2 minutes before starting episiotomy repair, until the end of the procedure. The control group received 5 mL of lidocaine (2%) before starting the episiotomy. The results of 2 groups were compared with regard to the pain intensity using a visual analog scale (VAS). Mann-Whitney, student’s t test, and chi square test were used to analyze the data.
Sixty women were studied in each group. Nine participants (15%) in nitrous oxide group, as opposed to 23 (38.4%) in lidocaine group, had moderate, severe or extremely severe pain (P = 0.005). In terms of satisfaction level, there was no significant difference between 2 groups (P = 0.713).
The results of this study showed that pain intensity in the nitrous oxide group was significantly lower than that in the lidocaine infiltration group. Application of nitrous oxide at least 2 minutes before repair may be an effective method for pain management in episiotomy repair.