Comparison between Lidocaine Spray and Cryotherapy for Pain Reduction from Amniocentesis in Second Trimester Pregnancy; A randomized controlled trial
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Abstract
Objectives: To compare the pain level from amniocentesis between lidocaine spray, cryotherapy prior to the procedure and control groups in second trimester pregnant women.
Materials and Methods: This was a prospective randomized-control trial study. It was conducted at Maternal and Fetal Medicine clinic at Thammasat University Hospital, Pathum Thani, Thailand between July 2021 and December 2021. Participants were pregnant women undergoing amniocentesis at gestational ages between 15 and 20 weeks. They were divided into three groups namely lidocaine, cryotherapy, and control. Subjects in lidocaine or cryotherapy groups received an administration of 8 spritzes of 10% lidocaine (80 mg) spray or cold gel packs (-18 to -24 degrees Celsius) onto the marked puncture site for five minutes before amniocentesis, respectively. The control group underwent amniocentesis in the same manner without any analgesia. Anticipated pain (Te), pain during the procedure (T0), 15 and 30 minutes after the procedure (T15 and T30) were evaluated based on 10-cm visual analog scale (VAS).
Results: A total of 330 pregnant women were recruited and allocated (110 cases per group). Mean maternal age was 36.1 years old. The demographic characters of the three groups were comparable. Pregnant women who received lidocaine had significantly less pain than control at T0, T15 and T30 (3.00 ± 2.18 vs 3.97 ± 2.27, p = 0.001, 0.95 ± 1.41 vs 1.95 ± 1.75, p < 0.001, 0.48 ± 1.11 vs 0.95 ± 1.28, p = 0.004, respectively). Those who received cryotherapy had significantly less pain than control at T0 and T15 (3.39 ± 1.84 vs 3.97 ± 2.27, p = 0.038 and 1.48 ± 1.49 vs 1.95 ± 1.75, p = 0.032, respectively). Lidocaine had less pain level than cryotherapy group at T15 and T30 (0.95 ± 1.41 vs 1.48 ± 1.49, p = 0.008 and 0.48 ± 1.11 vs 0.93 ± 1.20, p = 0.005, respectively).
Conclusion: Participants in both the lidocaine spray and cryotherapy groups had comparable pain levels during the procedure. In contrast, at 15 and 30 minutes after the procedure, the lidocaine spray group had less pain than the cryotherapy group.
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