Comparison of Outcomes of Incisional Infiltration with Lidocaine and Epinephrine Versus Lidocaine at the End of Cesarean Section Operation

The pain after the surgery is an important clinical problem. Until now a lot of methods for reducing pain after surgery have been evaluated. Because of the high prevalence of cesarean section and this point that pain after cesarean section can influence the healthy state of mothers and infants, this study with purpose of comparing of outcome of incisional infiltration with Lidocaine and Epinephrine versus Lidocaine in the end of cesarean section has been planned.

This study has been performed on 100 pregnant women with term pregnancy that were candidate for elective cesarean with spinal anesthesia. Patients were randomly divided to two groups including, group of 20 ml 2% Lidocaine or 20 ml solution of 1/4 of 1 mg/ml Epinephrine in 50cc of 2% Lidocaine (1/200000 dilution) that has been infiltrated in the subcutaneous after cesarean and before closing the skin. The measure of pain and narcotic use after surgery, the time of first lactating, to get out of bed , and discharge time of patients from hospital were compared between two groups with statistical tests, independent t, fisher exact test , and chi-square .

The results of this study showed that patients who have received Lidocaine and Epinephrine in the incisional site after cesarean versus patients who have received Lidocaine alone meaningfully started lactating sooner (P=0.018) and discharged sooner from hospital (P=0.010). Also, these individuals experienced less pain intensity from the 4 hours postoperatively until the end of the first day after the operation, compared to the lidocaine group (P<0.001), and the use of pethidine on the first day was less than that of the opposite group (P<0.001).

It seems adding Epinephrine to the local anesthetics like Lidocaine can prolong the effect of anesthetics and can reduce the doses of narcotic use after surgery and also can reduce the time of first lactating and discharge from hospital.