Background: Despite advances in multimodal analgesia, many women still experience inadequate pain control after cesarean delivery. The intraperitoneal use of local anesthetics has proven effective in postoperative pain reduction after open or laparoscopic abdominal surgery.
Objectives: We intended to evaluate the efficacy of intraperitoneal lidocaine instillation for relieving postoperative pain in women underwent elective cesarean sections.
Patients and methods: A randomized, placebo-controlled, triple-blinded trial carried out at Department of Obstetrics and Gynecology, Menoufia University Hospital. The study comprised 70 term pregnant women underwent elective cesarean sections through the period from September 2022 to March 2023. They were randomly divided into two equal groups. Lidocaine group < /strong> (comprised 35 participants who were administered 50 ml of 2% lidocaine intraperitoneally). Placebo group < /strong> (comprised 35 participants who were administered 50 ml of normal saline intraperitoneally). Primary outcome was postoperative pain scoring (via visual analogue scale) in the first 24 hours after cesarean delivery. Secondary outcomeswere mobilization onset, breastfeeding onset, side effects of medications, hospital stay duration, and patient satisfaction level in regard to pain control.
Results: Visual analogue pain intensity scores estimated at 4, 6 and 12 hrs after caesarean section were significantly lower among lidocaine group than placebo (P < 0.001). Lidocaine was significantly superior to placebo in terms of patient's overall satisfaction score with regards to pain control, the vast majority of candidates in lidocaine group (94.3%) were satisfied with their pain control versus 57.1% of candidates in placebo group (P<0.001).
Conclusion: Intraperitoneal lidocaine instillation is simple, safe and cost-effective option that can maximize patient's overall satisfaction with regards to post-cesarean analgesia.