The Comparison of Efficacy between Lidocaine-prilocaine Topical Cream and Mefenamic Acid for Postpartum Perineal Pain

Aims and background: Postpartum perineal pain can hinder daily activities such as personal hygiene, lactation, and caring for the newborn.Approximately, 92% of women, regardless of whether they had perineal damage or not, reported experiencing pain throughout the initial day of natural postpartum care.The comprehensive approach to managing postpartum perineal pain involves both pharmaceutical and nonpharmacological methods of pain treatment.The aim of this study was to compare the efficacy of topical lidocaine-prilocaine cream and mefenamic acid on postpartum perineal pain.Materials and methods: An experimental study was carried out at the Obstetrics and Gynecology Department of Mohammad Hoesin Hospital Palembang from January to June 2023.The study followed a double-blind, placebo-controlled design.A total of 40 participants met the inclusion and exclusion criteria, divided into groups of lidocaine-prilocaine cream and oral mefenamic acid.The primary measure studied was the effectiveness of the medicine in relieving pain, which was evaluated using the visual analogue scale (VAS) score at specific time points after childbirth (2, 6, 12, and 24 hours).The efficacy of the two therapies was then compared.The data were analyzed using SPSS version 25.0, with a significance level set at p < 0.05 and a 95% confidence interval (CI).The Shapiro-Wilk test was used for data homogenicity, paired t-test for treatment efficacy, and unpaired t-test for comparison of efficacy.Results: A total of 40 subjects were enrolled (n = 20 in each group).Most of the subjects were >30 years old (47.5%), lived in urban areas (72.5%, p = 0.480), middle income (p = 0.465), high level of education (87.5%, p = 0.196), overweight (55%), multipara (72.5%, p = 0.675), and had grade II perineal lacerations (82.5%, p = 1.000).The average VAS score for postpartum perineal pain was 6.50 0.88 in the group that received mefenamic acid, and 6.25 1.21 in the group that received lidocaine-prilocaine cream.Both oral mefenamic acid and lidocaine-prilocaine cream were shown to be efficacious in alleviating perineal pain (p = 0.000).The average VAS score at 24 hours after childbirth was 1.85 in the group that used lidocaine-prilocaine cream and 2.10 in the group that took oral mefenamic acid.The efficacy of lidocaine-prilocaine cream was superior to that of oral mefenamic acid in the treatment of postpartum perineal pain within a 24-hour period (p = 0.025).The drug acceptability was excellent and there was no drug adverse effect occurred. Conclusion:In the 24 hours after childbirth, the use of lidocaine-prilocaine cream is more effective than using oral mefenamic acid for relieving pain in the perineal area.Clinical significance: Lidocaine-prilocaine cream can be used as alternative for postpartum perineal pain in the 24-hour postpartum.