JCOGP
Journal of Controversies in Obstetrics & Gynecology and Pediatrics

As of January 2023, our "Journal of Controversies Obstetrics & Gynecology and Pediatrics" has been published under the Medihealth Academy to publish all articles, reviews and case reports on Pediatrics, especially in the field of Obstetrics and Gynecology. In order to facilitate the citation of the articles, to take our place in internationally respected indexes and to reach a wider readership, we will pay attention to the fact that our article language is only English in terms of acceptance. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

eISSN: 2980-0579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
Randomized controlled study of intradermal sterile water injection and intradermal lidocaine injection in obstetric analgesia
Abstract
Aims: In today’s world, the increasing desire for normal and uninterrupted delivery in pregnant women has brought the need to combat labor pain and non-pharmacological techniques to the agenda again. These methods should be reconsidered in order to increase their analgesia effectiveness and to popularize their use.
Methods: In our study, intradermal sterile water (SW) injection technique, which is one of the non-pharmacological techniques, was used and the effects of intra-injection saline and lidocaine were compared. 128 patients were included in our study, and 64 patients were injected with intradermal SW and 64 patients were injected with intradermal lidocaine to provide analgesia. During labor follow-up, durations of labor phases, dilatation and effacement rates were recorded, along with Visuel analoque scale (VAS) scoring and delivery type, episiotomy application, operative delivery, cesarean section, and apgar data. At the end of the delivery, the patient's satisfaction with the procedure, the degree of pain reduction and her willingness to use this method again were questioned and recorded.
Results: Between groups, statistically significant results such as 1st hour dilatation (p = 0.02), 30th minute VAS (p = 0.02), were obtained. No maternal and fetal side effects were recorded during the study, and no significant difference was found in terms of cesarean delivery episiotomy and neonatal outcomes.
Conclusion: Lidocaine injection can be considered superior to SW injection because its positive effect on VAS score lasts longer.

Keywords : Obstetric analgesia, intradermal injection, non-pharmacological pain control techniques

Download Article


1. Lawrence L, Fontaine P, King V. “The nature and management oflabor pain: part I. Nonpharmacologic pain relief.”Am Fam Physician.200;68(6):1109-1112.
2. Cunningham FG, Leveno KJ, Bloom ST, et al. Williams obstetrics 25thed. New York: McGraw-Hill. 2018;(1)508.
3. Wong, CA. Labor analgesia: is there an ideal technique? Anesthesia andAnalgesia. 2009;09(2):296-298.
4. Pandya ST. Labour analgesia: recent advances. Indian J Anaesth.2010;54(5):400-408. doi.org/10.4103/0019-5049.71033
5. Silva M, Halpern SH.Epidural analgesia for labor: current techniques.Vet Anaesth Analg. 2010;3(1):143-153. https://doi.org/10.2147/LRA.S10237
6. Somuah M, Smyth RMD, Cyna AM, Cuthbert A. Epidural versus non-epidural or no analgesia for pain management in labour. CochraneDatabase Syst Rev. 2018;5(5):000331. doi.org/10.1002/14651858.CD000331.PUB4
7. Eltzschig HK, Lieberman ES, Camann WR. Regional anesthesia andanalgesia for labor and delivery. N Engl J Med. 2003;348(4):319-332.https://doi.org/10.1056/NEJMRA021276
8. Simmons SW, Taghizadeh N, Dennis AT, Hughes D, Cyna AM.Combined spinal-epidural versus epidural analgesia in labour.Cochrane Database Syst Rev. 2012;10(10).D003401
9. Gomar C, Fernandez C. Epidural analgesia-anaesthesia in obstetrics.Eur J Anaesthesiol. 2000;17(9):542-558. https://doi.org/10.1046/J.1365-2346.2000.00733.X
10. Bonapace J, Gagné GP, Chaillet N, Gagnon R, Hébert E, Buckley S.Physiologic basis of pain in labour and delivery: an evidence-basedapproach to its management. J Obstet Gynaecol Can.2018;40(2):227-245.
11. Hodnett ED. Pain and women’s satisfaction with the experience ofchildbirth: a systematic review. Am J Obstet Gyneco. (2002;186):160-172.
12. Lee N, Coxeter P, Beckmann M, et al. A randomised non-inferioritycontrolled trial of a single versus a four intradermal sterile waterinjection technique for relief of continuous lower back pain duringlabour. BMC Pregnancy and Childbirth. 2011;(23):11-21.
13. Lytzen T, Cederberg L, Möller-Nielsen J.Relief of low back pain in laborby using intracutaneous nerve stimulation (INS) with sterile waterpapules. Acta Obstet Gynecol Scand. 1989;68(4), 341-343. doi.org/10.3109/00016348909028669
14. Jones L, Othman M, Dowswell T, et al. Pain management for women inlabour: an overview of systematic reviews. Cochrane Database Syst Rev.2012;(3):009234.
15. Ader L, Hansson B, Wallin G. Parturition pain treated byintracutaneous injections of sterile water. Pain. 1990,41(2):133-138.doi.org/10.1016/0304-3959(90)90017-8
16. Bahasadri S, Ahmadi-Abhari S, Dehghani-Nik M, & Habibi GR.Subcutaneous sterile water injection for labour pain: a randomisedcontrolled trial. J Extracell Vesicles. 2006;46(2):102-106. https://doi.org/10.1111/J.1479-828X.2006.00536.X
17. Kushtagi P, Bhanu BT. Effectiveness of subcutaneous injection of sterilewater to the lower back for pain relief in labor. Acta Obstet GynecolScand. 2009;88(2):231-233. https://doi.org/10.1080/00016340802635534
18. Mårtensson L, Wallin G.Sterile water injections as treatment for low-back pain during labour: a review. J Extracell Vesicles. 2008;48(4), 369-374. https://doi.org/10.1111/J.1479-828X.2008.00856.X
19. Trolle B, Moller M, Kronborg H, Thomsen S.The effect of sterile waterblocks on low back labor pain. Am J Obstet Gynecol.1991;164(5-1):1277-1281.
20. Wiruchpongsanon P. Relief of low back labor pain by usingintracutaneous injections of sterile water: a randomized clinical trial. JMed Assoc Thai. 2006;89(5):571-576.
21. Labrecque M, Nouwen A, Bergeron M, Rancourt JF. A randomizedcontrolled trial of nonpharmacologic approaches for relief of low backpain during labor. J Fam Pract. 1999;48(4):259-263.
22. Mårtensson L, Stener Victorin E,Wallin G. Acupuncture versussubcutaneous injections of sterile water as treatment for labourpain. Acta Obstet Gynecol Scand. 2008;87(2):171-177. https://doi.org/10.1080/00016340701797799
23. Fogarty V. Intradermal sterile water injections for the relief of low backpain in labour: a systematic review of the literature. Women Birth.2008;21(4):157-163. https://doi.org/10.1016/J.WOMBI.2008.08.003
24. Zeilhofer HU, Wildner H, Yévenes GE. Fast synaptic inhibition inspinal sensory processing and pain control. Physiol Rev.2012;92(1):193-235. https://doi.org/10.1152/PHYSREV.00043.2010
25. Lee N, Mårtensson LB, Homer C, et al. Impact on caesarean sectionrates following injections of sterile water (ICARIS): a multicentrerandomised controlled trial. BMC Pregnancy Childbirth. 2013;3(13):105.
26. Fadaizadeh L, Emami H, Samii K. Comparison of visual analogue scaleand faces rating scale in measuring acute postoperative pain. Arch IranMed. 2009;12(1):73-75.
27. ACOG Practice Bulletin No. 209: Obstetric Analgesia and Anesthesia.Obstet Gynecol. 2019;(133):208-225
28. Lee N, Coxeter P, Beckmann M, et al. A randomised non-inferioritycontrolled trial of a single versus a four intradermal sterile waterinjection technique for relief of continuous lower back pain duringlabour. BMC Pregnancy and Childbirth. 2011;(11):21.
29. Reynolds JL. CME Intracutaneous sterile water for back pain in labour.Can Fam Physician. 1994;(40)1785-1792.
30. Simkin P, Klein MC. Nonpharmacological approaches to managementof labor pain. UpToDate online. 2007.
Article available in :
Volume 2, Issue 3, 2024
Page : 46-50
https://doi.org/10.51271/JCOGP-0034
Article Information
Received : 15 Nis 2024
Accepted : 28 Nis 2024
Published : 30 Tem 2024
Corresponding Author :

Birsen Konukcu: Department of Obstetrics and Gynecology, Perinatology Unit of Antalya State Hospital, Antalya, Turkiye

[email protected]
Citation : Konukcu B, Özkaya E, Kobal BB. Randomized controlled study of intradermal sterile water injection and intradermal lidocaine injection in obstetric analgesia. J Controv Obstetr Gynecol Ped. 2024;2(3):46-50.

Read: 469
Cited: 0
Download : 132
_Footer