Effects of cinnamon on perineal pain and healing of episiotomy: a randomized placebo-controlled trial

BACKGROUND: Analgesic and wound-healing effects of cinnamon, a widely used spice, have been shown in laboratory rats. However, we found no human studies in this area.OBJECTIVE: The aim of this study was to assess the effect of cinnamon on perineal pain and healing of episiotomy incision.DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: In this double-blind, randomized, placebo-controlled trial, 144 postpartum women were allocated into two groups, using stratifi ed block randomization, 1 h after completion of episiotomy repair. They received cinnamon or placebo ointment, 2 mL every 12 h for 10 d.MAIN OUTCOME MEASURES: Perineal pain and wound healing were assessed using visual analogue scale(0-10) and Redness, Edema, Ecchymosis, Discharge, Approximation scale(0-15), respectively. General linear model was used to compare the groups on the outcomes adjusted for baseline values and stratifi ed factors.RESULTS: Follow-up rate was 100% up to the 8 h time point in both groups, and 86%(62 of 72) in the cinnamon group and 85%(61 of 72) in the placebo group at day 10-11 after delivery. Pain score in the cinnamon group was signifi cantly lower than that in the placebo group at(4±1) h(adjusted difference:-0.6, 95% confi dence interval:-1.0 to-0.2) and(8±1) h(-0.9,-1.4 to-0.3) after intervention, and on the 10-11 th day after delivery(-1.4,-2.0 to-0.7). Also the cinnamon group showed signifi cantly more improvement than the control group in healing score at(8±1) h(-0.2,-0.4 to-0.04) and the 10-11 th day after delivery(-1.6,-2.0 to-1.1). CONCLUSION: Cinnamon can be used for reducing perineal pain and improving healing of episiotomy incision.     

生理盐水联合甲硝唑注射液冲洗并湿敷在会阴侧切伤口中的应用研究

目的：探讨生理盐水联合甲硝唑注射液冲洗并湿敷在会阴侧切伤口中的应用效果。方法将282例经阴道分娩行会阴侧切术的初产妇,随机均分为研究组和对照组（n=141）。研究组缝合前先用生理盐水冲洗,常规缝合后产妇每天用1∶20碘伏溶液擦洗会阴切口,然后敷上甲硝唑注射液浸湿的无菌纱布。对照组常规缝合后每天仅用1∶20碘伏溶液擦洗。观察记录2组患者术后不良反应、拆线天数和切口愈合情况。结果研究组甲级愈合人数显著高于对照组,2组差异有统计学意义(P<0.05);研究组拆线天数为（4.5±0.65）d,显著低于对照组的（6.12±0.85）d,2组差异有统计学意义(P<0.05);研究组会阴切口有红肿、血肿、化脓等不良反应人数均低于对照组,2组差异有统计学意义(P<0.05)。结论生理盐水联合0.5%甲硝唑注射液冲洗并湿敷是较理想的护理方法,经济方便,值得在临床推广。     

会阴阻滞麻醉联合会阴体按摩对会阴侧切及裂伤的影响

目的：研究会阴体按摩联合会阴阻滞麻醉在减少会阴侧切及裂伤中的临床应用效果。方法选择200例产妇,并均分为观察组和对照组（n=100)。观察组采用会阴体按摩+会阴阻滞麻醉,对照组采用传统的会阴侧切+会阴阻滞麻醉,观察2组的会阴侧切率、裂伤率以及并发症发生率。结果观察组的会阴侧切率、裂伤率以及并发症发生率为51.0%、9.0%、3.0%,均显著低于对照组的83.0%、28.0%、10.0%,差异有统计学意义（P＜0.05）。结论在原有成熟的会阴阻滞麻醉技术上加上会阴按摩增强会阴的局部弹性,减少产妇的会阴侧切及裂伤,可以有效地减降低会阴侧切及裂伤率和会阴伤口并发症的发生率,从而极大减轻产妇的疼痛感,减少住院费用及住院时间,减少医疗纠纷。     

分娩会阴侧切和自然裂伤与盆底功能的相关性

目的 探讨初产妇分娩时行会阴侧切和自然裂伤与盆底功能近期改变的相关性.方法 收集宁波市镇海龙赛医院产科2012年6月至2014年3月确定为阴道生产的初产妇150例,分为会阴侧切组(85例)、自然裂伤组(35例)、自然顺产分娩组(30例),分别对3组同期同时在产后42天后,通过问卷调查、详细的身体检查、盆底相关肌肉检查,评估其盆底功能变化以及分别于自然顺产组相比的OR值.结果 分娩时压力性尿失禁、排尿困难的发生率在3组之间的比较差异均无统计学意义(x2值分别为4.670、1.085,均P＞0.05);会阴伤口疼痛、性生活障碍的发生率在3组之间比较差异均有统计学意义(r值分别为25.929、27.525,均P＜0.05).盆底肌力分级在3组之间比较差异有统计学意义(x2=10.869,P＜0.05),肌电位的比较差异也具有统计学意义(F=6.689,P＜0.05).盆底肌力分级会阴侧切组与自然顺产组相比OR=1.450,自然裂伤组与自然顺产组相比OR=1.023,盆底功能与会阴侧切、自然裂伤的相关系数(r)分别为1.123和1.458,均P＜0.05.结论 分娩时会阴侧切、自然裂伤对盆底功能的影响大于自然顺产,但是会阴侧切的影响重于自然裂伤.     

Evaluation of In Vivo Properties of Velosorb™ Fast Versus Vicryl™ Rapide in a Functional Rabbit Model of Intradermic Suture and Episiotomy

Objective: Fast-absorbing polyglactin 910 is commonly used to suture skin and vaginal incisions. In vitro studies have shown similar tensile strength properties between Velosorb? Fast and Vicryl? Rapide (Al-Qattan MM. J Hand Surg Br Eur. 2005;30(1):90–91). This randomized study compared Velosorb? Fast (Covidien) with Vicryl? Rapide (Ethicon) in a rabbit model of intradermic suture and episiotomy. Materials and Methods: This randomized prospective study was performed on 20 New Zealand rabbits, in which we realized a mediolateral perineo-vaginal incision and two vertical skin incisions of about 8 cm on the abdominal wall. The sutures were randomized between Velosorb? Fast (Covidien) and Vicryl? Rapide (Ethicon), and each rabbit was treated with the same suture on both vaginal incision and left abdominal incision, while the right abdominal incision was closed with an alternate suture. A macroscopic examination was performed on days 5 and 11. On day 11, animals were sacrificed for histological (Badylak quantitative score) and electron microscopic examinations. Differences were considered significant at p < .05. Results: All of the rabbits survived and were included in the final results. Fifty-one sutures were visible by histologic analysis (27 in the Velosorb? Fast group and 24 in the Vicryl? Rapide group). The power of the study was ≥80%. There was no significant difference between the two groups based on the total histologic Badylak score analysis or the Badylak sub-score analysis. Conclusions: Velosorb? Fast seems to be as efficient as Vicryl? Rapide for use in perineal and skin closure.     

Risk factors for acute postpartum urinary retention after vaginal delivery: focus on episiotomy direction

Objective: This study aimed to investigate the independent factors for acute postpartum urinary retention (APUR) after vaginal delivery.

Methods: From January 2008 to December 2013, 98 patients with APUR after vaginal delivery without instrument use were compared with 108 control patients matched by age and medical history. Multivariate logistic regression analysis was performed to identify independent risk factors for APUR. Predictive accuracy for the multivariate model was assessed using the derived area under a receiver operating characteristics curve.

Results: Among maternal previous partial history, mean live birth history was lower in the APUR group (0.12 versus 0.31, p?=?0.017). Regional anesthesia use (76.5% versus 60.2%, p?=?0.036), mediolateral episiotomy (63.3% versus 31.5%, p?<?0.001) and labor time were significantly higher in the APUR group. Multivariate logistic regression analysis showed that mediolateral episiotomy, labor time and the presence of regional anesthesia were independent contributing factors for the development of APUR. This model’s predictive accuracy for APUR was 73.1%.

Conclusion: Prolonged labor time, regional anesthesia and mediolateral episiotomy were independent factors for APUR. Therefore, we considered median episiotomy to be the best approach during vaginal delivery avoiding APUR.     

专项整治前后会阴侧切术抗菌药物用药情况的调查分析

目的：评价开展抗菌药物专项整治活动对本院会阴侧切术患者抗菌药物合理应用的作用。方法回顾性分析本院开展抗菌药物专项整治前（2010年10~12月）、后（2013年10~12月）会阴侧切术患者的临床资料和抗菌药物应用情况。结果本院经过抗菌药物专项整治后,会阴侧切术患者的抗菌药物应用率由整治前的51.0%下降至整治后的25.2%;以预防用药为目的抗菌药物使用率由整治前的48.6%下降至整治后的22.6%;单药应用率由整治前的50.4%下降至整治后的25.0%;非限制使用类抗菌药物所占比例由50.6%降至24.2%（P＜0.05）;限制使用类抗菌药物所占比例由0.4%升至1.0%;二联用药率由整治前的0.6%下降至整治后的0.2%（P＞0.05）。结论抗菌药物专项整治对本院会阴侧切术患者合理应用抗菌药物有明显促进作用,会阴侧切术抗菌药物使用率呈明显下降趋势,促进了临床合理用药。     

改良麻醉方法在会阴切开镇痛中的效果观察

目的 探讨经阴道分娩的产妇改良会阴麻醉方法的临床应用效果.方法 将200例经阴道分娩行会阴切开术,无妊娠合并症的产妇随机分为两组各100例.会阴切开时按摩阿氏穴镇痛,缝合时应用0.5%利多卡因局部浸润和湿敷处理者为改良组,传统浸润麻醉者为对照组.产后护理和治疗均相同.比较两组产妇会阴麻醉镇痛效果、切口出血量、缝合时间、肿胀和愈合情况.结果 改良组镇痛效果优于对照组(P＜0.01);改良组切口出血、缝合时间、肿胀明显少于对照组(P＜0.01);两组会阴切口甲级愈合无显著差异(P＞0.05).结论 改良局部浸润麻醉方法符合产妇生理需求,且操作简便.临床应用效果明显优于传统局部浸润麻醉方法.