The effects of lidocaine and mefenamic acid on post-episiotomy pain: a comparative study.

Background: Most women suffer pain following an episiotomy and oral non-steroidal anti-inflammatory drugs are commonly used for pain relief. Due to the gastrointestinal side effects of oral drugs, it seems that women are more accepting of topical medications for pain relief. Objectives: Therefore, the aim of this study was to compare the effects of lidocaine and mefenamic acid on post-episiotomy pain. Patients and Methods: This clinical trial was carried out in 2011. It involved sixty women with singleton pregnancy who were given an episiotomy at 38 to 42 weeks of gestation. The participants were randomly divided into two groups. One group received 2% lidocaine cream (n = 30), while the other group received 250 mg of mefenamic acid (n = 30). The data were collected via a questionnaire and a visual analog scale. Pain intensity was compared from the first complaint by the mother and at 6, 12, and 24 hours after the delivery in both groups. The data were analyzed using SPSS (version 16), the t-test, and the paired t-test, and a P value of less than 0.05 was considered significant. Results: The mean intensity of pain at the first compliant was 4.92 ± 1.9 in the lidocaine group and 4.90 ± 1.5 in the mefenamic acid group, and the difference was not statistically significant (P = 0.20). Additionally, there was no significant difference in the mean intensity of post-episiotomy pain between the two groups at 6 (P = 0.05), 12 (P = 0.36), and 24 (P = 0.98) hours after childbirth. Conclusions: The effects of the lidocaine cream and mefenamic acid were similar in terms of the relief of post-episiotomy pain. Lidocaine cream therefore represents a good alternative to mefenamic acid, which is commonly used to reduce pain following an episiotomy, especially in women who are breastfeeding and who wish to avoid oral analgesic drugs being secreted in their milk. © 2016, Shiraz University of Medical Sciences.