BMJ  2006;333:108-109 (15 July), doi:10.1136/bmj.333.7559.108

Editorial

Analgesia in the second stage of labour

Simple interventions would be welcome, but lidocaine spray on the perineum does not reduce pain

The first 150 words of the full text of this article appear below.

In this week's BMJ, Sanders and colleagues report a randomised controlled trial of an easy non-invasive intervention in labour: using lidocaine spray on the perineum as the baby's head is delivered.¹ Labour pain has been described as one of the most extreme forms of pain.² It is caused by uterine contractions, by dilatation of the cervix, and by stretching of the pelvic floor and vagina as the fetus descends. Epidural analgesia and its variants (combined spinal-epidural) are the most effective type of analgesia during labour, according to a Cochrane review in which all but one of the 21 included trials compared epidurals with opiates.³ Hence this method is frequently used to relieve the pain associated with labour.

In many countries and settings epidural analgesia is rarely available. Even when it is available, some women may bear the pain until the second stage of labour. Non-pharmacological interventions including continuous . . . [Full text of this article]

Department of Obstetrics and Gynecology, Maternité-HUG, Geneva 14, CH-1211, Switzerland
(michel.boulvain@hcuge.ch)

Department of Obstetrics and Gynecology, Maternité-HUG, Geneva 14, CH-1211, Switzerland

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