Acute pain management after vaginal delivery with perineal tears or episiotomy
Methodological detailsMEDLINE, Embase, Cochrane searched for RCTs and systematic reviews until March 2023; quality graded with Cochrane Covidence tool and RoB Vis 2
- MEDLINE, Embase, Cochrane searched for RCTs and systematic reviews until March 2023; quality graded with Cochrane Covidence tool and RoB Vis 2
Recommendations
As issued by the authors
Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) recommended as first-line treatment
Epidural morphine (≤2 mg) recommended in women with labor epidural analgesia and severe perineal tears, with adequate respiratory monitoring
Local anesthetic infiltration, topical local anesthetic, ointment application and pudendal nerve block not recommended (insufficient or lack of evidence)
Ice or chemical cold packs recommended as first-line treatment
Transcutaneous nerve stimulation and acupuncture recommended as adjuvants
Continuous vs interrupted suture recommended for repair of episiotomy or second-degree tears (outcome: pain)
No suturing or glue vs suturing recommended for first- or second-degree tears (outcome: pain)
Original publication
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