Pre-incisional, post-incisional and combined pre- and post-incisional local wound infiltrations with lidocaine in elective caesarean section delivery: a randomised clinical trial.

The objective of this study was to compare maternal and fetal outcomes in caesarean deliveries received pre-incisional, post-incisional or combined pre- and post-incisional local wound infiltrations with lidocaine. In a randomised, double-blind clinical trial, candidates of elective caesarean section received local wound infiltration with an anaesthetic mixture including 1% lidocaine pre-incisionally (n = 94), post-incisionally (n = 92) or both (n = 95). Postoperative pain, duration of analgesia, number of postoperative rescue analgesic demands, time to ambulation, time of first breast-feeding and neonatal Apgar score were compared. Main outcome variables were comparable between the pre- and post-incisional groups. Pain scores and duration of analgesia were significantly lower in the mixed group. Time of breast-feeding and number of analgesic demand were significantly lower in 'mixed' group than those in pre- and post-incisional groups, respectively. The other variables were comparable. Combined pre- and post-incisional local wound infiltration in post-caesarean pain relief is superior to each one alone.