Analgesia in the second stage of labour

doi:10.1136/bmj.333.7559.108

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Michel Boulvain, consultant (michel.boulvain@hcuge.ch),
Michel-Ange Morales, consultant

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

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

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 …