Douglas pouch lidocaine infiltration in reducing pain scores in elective cesarean sections: randomized clinical trial

Objectives: to compare the effects of infiltration of lidocaine into the Douglas pouch on postoperative pain scores in elective cesarean sections done under general anesthesia compared to infiltration with saline only. Methods: a randomized clinical trial done in obstetrics and gynecology department-Benha faculty of medicine in which one hundred cases scheduled for elective CS were randomly allocated . the cases allocated to receive infiltration of either 1% lidocaine (in the Douglas pouch) or saline .The pain intensity and analgesic demand after CS, as well as the time to ambulation and breast feeding, were documented and compared between the groups. Main outcome measures: reduction of pain scores after labour. .Secondary outcomes: early ambulation and breast feeding and reduced need for rescue analgesia. Results: Post cesarean section pain intensity and analgesic demand were significantly lower, and the time to ambulation was significantly less in the lidocaine group than in the placebo group. Pain score mean was 2.1 in lidocaine group .compared to 6.06 in placebo group with (Pvalue<0.0001). Conclusion: infiltration of lidocaine in Douglas pouch intra-operatively inelective cesarean sections significantly lower visceral pain scores and allowearly ambulation and breast feeding.