EVALUATION OF THE ANALGEMIC EFFECT OF EMLA 5% AT THE SITE OF SPINAL AND EPIDURAL ANESTHESIA FOR WOMEN UNDERGOING C-SECTION

Văn Út Trần, Đức Lam Nguyễn, Trọng Hưng Mai

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Abstract

Objective: To evaluate the analgesic effect at the spinal and epidural anesthesia sites of EMLA 5% anesthetic in women undergoing cesarean section.Methods: Clinical interventional, descriptive, cross-sectional, controlled study. 120 women were randomly divided into three groups: Group L (using only lidocaine, n=40), Group E (using only EMLA 5%, n=40) and Group E/L (using a combination of EMLA 5% and lidocaine 1%, n=40), to evaluate and compare the pain level at each time point during spinal anesthesia and epidural analgesia. Results: The results showed that the pain relief effect of group E/L and group E was similar (p>0.05) and better than group L (p<0.05) during spinal anesthesia, the rates of no pain, mild pain, moderate pain, severe pain were 62.5%; 3.5%; 0%; 0% in group E/L and group E compared to 0%; 2.5%; 2.5%; 25% in group L. During epidural analgesia, group E/L had better pain relief than group E and group L when the Touhy needle passed through the skin, the rates of no pain were (40%; 7.5% and 35% p<0.05, respectively). Group L had better pain relief than group E when the Touhy needle passed through the subcutaneous tissue and ligaments, (the rate of severe pain was 0% compared to 35%, p<0.05). Seven mothers in group E (17.5%) requested additional anesthetic when the Touhy needle passed through the subcutaneous tissue and ligaments. The satisfaction level of mothers after the procedure was highest in group E/L, significantly higher than those of group E and group L (p<0.05), (the rates of very satisfied, satisfied, and dissatisfied were 32.5%; 6.5%; 0%, respectively). Conclusion: Combination of EMLA 5% before spinal anesthesia and lidocaine 1% to infiltrate the ligament before placing the epidural catheter gives the best pain relief effect. EMLA 5% provides good pain relief during spinal anesthesia but is not enough to relieve pain at the time the Touhy forceps pass through the subcutaneous tissue and ligaments.

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References

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