Intraperitoneal lidocaine instillation and postcesarean pain after parietal peritoneal closure: a randomized double blind placebo-controlled trial

Abstract

Objective: To evaluate the effects of intraperitoneal instillation of lidocaine on postcesarean pain in patients with pariental periotoneal closure.

Methods: A sample of 370 pregnant women, presenting early in labor, with no history of abdominal surgery and with indications for cesarean section were operated on with closure of the parietal peritoneum. They randomly received either 200 mg of intraperitoneal lidocaine or sterile saline (0.9%). Pain scores on the first and fifteenth postoperative days were recorded and followed up every 2 weeks up to 8 months after surgery.

Results: Overall incidence and pain scores of epigastric and global abdominal pain were more frequent in the controls than in the lidocaine group. The incidence of persistent postcesarean pain after 8 months dropped from 20.8.0% to 10.8% (P<0.001) when intraperitoneal lidocaine was instilled.

Conclusions: Intraperitoneal instillation of 200 mg of lidocaine decreased the incidence and scores of postcesarean pain when the parietal peritoneum was sutured. Further studies in a setting offering more effective acute pain control protocols, preferably with patient-controlled analgesia, are recommended to assess the use of lidocaine before it can be widely practiced.