Efficacy of lidocaine local anesthesia on pain perception during amniocentesis: A meta-analysis of randomized controlled trials

Ebraheem Albazee; Reem Sayad; Mohammad Alnifise; Abdulrahman Al-Anzi; Faisal Alshammari; Gheith Rasheed; Ahmed Samy; Haifa Al-Jundy; Marwah Ghazi Bintalib; Ahmed Abu-Zaid

doi:10.4274/tjod.galenos.2022.99404

Efficacy of lidocaine local anesthesia on pain perception during amniocentesis: A meta-analysis of randomized controlled trials

Turk J Obstet Gynecol. 2022 Dec 13;19(4):327-332. doi: 10.4274/tjod.galenos.2022.99404.

Authors

Affiliations

¹ Kuwait Institute for Medical Specializations (KIMS), Kuwait City, Kuwait.
² Faculty of Medicine, Assuit University, Assuit, Egypt.
³ Faculty of Medicine, The Hashemite University, Zarqa, Jordan.
⁴ Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
⁵ Department of Obstetrics and Gynecology, Jahra Hospital, Jahra, Kuwait.
⁶ Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
⁷ Department of Obstetrics and Gynecology, Dr. Sulaiman Al-Habib Hospital, Riyadh, Saudi Arabia.
⁸ Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
⁹ College of Graduate Health Sciences, University of Tennessee Health Science Center, Tennessee, USA.

Abstract

To evaluate the efficacy of lidocaine local analgesia on maternal pain reduction during amniocentesis. Web of Science, Scopus, PubMed, and CENTRAL databases were screened from inception and updated in July 2022. The included randomized controlled trials (RCTs) were evaluated for the risk of bias via the Cochrane tool. The primary outcome was pain perception using the 10 cm visual analog scale, and was summarized as mean difference (MD) with 95% confidence interval (CI) in a random-effects model. Subgroup analysis was performed according to the mode of administration. Meta-analysis was done via Review Manager software. We included five RCTs totaling 1004 women (lidocaine arm n=502 patients and control arm n=502 patients). Overall, there was no significant difference between both arms [MD=-0.21, 95% CI (-0.48, 0.07), p=0.80]. The pooled analysis showed homogeneity (p=0.13, I2=43%). Subgroup analysis according to the mode of administration showed that pain perception did not significantly differ between both arms when lidocaine was employed as injection [n=3 RCTs, MD=-0.26, 95% CI (-0.76, 0.23), p=0.29] or non-injection [n=2 RCTs, MD=-0.18, 95% CI (-0.55, 0.18), p=0.33]. The pooled analyses showed heterogeneity (p=0.05, I2=66%) and homogeneity (p=0.27, I2=19%), respectively. There was no noteworthy change concerning maternal pain perception between the lidocaine and control arms. Most women reported just minimal discomfort during amniocentesis. Counseling should educate patients that the pain they might experience during amniocentesis is comparable to venous blood sampling.

Keywords: Amniocentesis; analgesia; local anesthesia; pain; pregnancy.