A random trial of three topical analgesic agents in the treatment of episiotomy pain following instrumental vaginal delivery

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Abstract
A random study of 300 mothers is described comparing the effectiveness of three topical agents (Epifoam, hama-melis water and ice) in achieving analgesia for episiotomy associated with forceps delivery. Data were collected in 266 women for immediate postnatal evaluation. All three agents were equally effective at achieving analgesia on the first day though approximately one-third of mothers derived no benefit from any agent. Ice had a tendency to be better thereafter. Whilst differences in the incidence and resolution of bruising and oedema were demonstrated, these differences were not reflected in the mother's perception of pain relief. At the postnatal clinic 126 mothers were assessed. No differences were found between the three groups in terms of healing, pain and intercourse patterns. All three preparations were effective at achieving analgesia. Epifoam did not have any clear benefits compared with cheaper methods.