efficacy of 2% lidocaine gel in pain relieving of episiotomy: a double-blind randomized trial

Episiotomy is the most common obstetric surgical and discomfort and pain is a common experience for all women exposed to episiotomy. This study was performed to investigate the efficacy of lidocaine gel 2% in pain relieving after episiotomy. In a randomized, double-blind, placebo-controlled trial, 150 women who had episiotomy were selected and received 5cc lidocaine gel 2% or a placebo every four hours after episiotomy repair. Then pain ratings were recorded before the administration of the drugs and at 6 and 12 hour after the first dose, according to a numerical rating scale. Data were analyzed using the unpaired t- test, and the Pearson [%2] test. A P value of less than .05 was considered statistically significant. Women using lidocaine gel had lower average pain scores, although this only reached statistical significance at 12 hours after delivery [p =0.009]. Mean pain score at this time was 2.63 +/- 2.01 in lidocaine group and 3.6 +/- 2.4 in placebo group. Also there was a significant difference between two group in consumption of analgesia in postpartum [P=0.034]. There weren't any adverse effect with lidocaine gel uses. This study suggested that lidocaine gel is a safe and simple drug that may be effective for episiotomy pain relief on first day of postpartum

Maternal haemodynamic effects of oxytocin bolus or infusion in the third stage of labour

The safety of bolus oxytocin has been questioned due to reports of maternal hemodynamic consequences. This study compared maternal haemodynamic effects of oxytocin bolus or infusion in the third stage of vaginal delivery. This was a randomized double-blind clinical trial in 170 women who received [10IU] intravenous oxytocin bolus or infusion in third stage of labour. Mean arterial pressure [MAP] and heart rate [HR] were measured before delivery and 1, 5, 10, 20 minutes after administration of oxytocin. These serial measurements and postpartum outcome were compared in two groups. Results were analyzed using analysis of variance for repeated measures, t-test, Man U Whitney, Fisher exact test, and chi-square test. Findings showed MAP and HR did not vary between two groups [p= 0.38 and p= 0.65 respectively. Length of the third stage of labour, retained placenta and reduction in haemoglobin concentration for the bolus group was less than infusion group [p=0.000, p=0.042 and P=0.036 respectively]. Other postpartum outcome was similar in two groups. Bolus oxytocin is not associated with adverse maternal hemodynamics and appeared to be as effective and can safely be administered in the third stage of labour

Oral versus nasal vasopressin in the treatment of nocturnal enuresis in 5-to 12-year-old children

Nocturnal enuresis is a common childhood problem and has various treatments. This study was carried out to compare oral and nasal vasopressin in the treatment of nocturnal enuresis in 5-to 12-year-old children who were referred to the Shahid Beheshti Clinic in 2008. This study included 100 children [62 males and 38 females] with nocturnal enuresis. One group [50 patients] received 20 mcg nasal vasopressin which increased up to 40 mcg, depending on the patients' response. The other group [50 patients] received 0.2 mg oral vasopressin which increased up to 0.4 mg. The patients were followed up for one month after response to the last dose of drug. Data were recorded in prepared forms and analyzed using Chi-Square and Fisher Test. The success rate with oral and nasal method was 80% and 92%, respectively [P=0.08]. Only 2% of the children had complications during the treatment; one child treated orally developed gastroenteritis and another child treated with the nasal method developed convulsions [P=1]. Sixteen percent of the children treated with the oral method and 28% of the children treated with the nasal method had recurrence [P=0.148]. Oral and nasal forms of vasopression have equal therapeutic effects. However, oral form of the treatment has fewer serious side effects and is easier to use. Therefore, the use of oral medicine is recommended