Xyla-P Cream vs. Lidocaine Spray: Impact on Patient Satisfaction, Anxiety, Cooperation, and Pain in Spinal Anesthesia for Cesarean Section

Background: One of the fundamental principles of medical interventions is to avoid causing pain to patients, and childbirth is no exception. With the rising prevalence of cesarean sections, addressing factors that may diminish maternal satisfaction is crucial. Spinal anesthesia, the most common method for cesarean sections, faces challenges such as patient anxiety. To mitigate pain associated with needle insertion, various methods, including lidocaine spray and Xyla-P cream, have been recommended. Objectives: This study aimed to evaluate the effectiveness of lidocaine spray and Xyla-P cream in reducing pain during needle insertion for spinal anesthesia in cesarean sections. Methods: This randomized, placebo-controlled interventional study included 263 pregnant women at 37 weeks or more of gestational age who were candidates for elective cesarean sections. Participants were randomly assigned to intervention and control groups using a block permutation technique. In intervention group 1, 10 g of Xyla-P cream was applied 30 minutes before spinal anesthesia. In intervention group 2, three puffs of 10% lidocaine spray were used. The control group received three puffs of water spray ten minutes before anesthesia. Pain intensity and anxiety were assessed using the Visual Analog Scale (VAS), and maternal cooperation was scored by the anesthesiologist. Results: The mean age of the participants was 30 years, and 21% had no prior history of cesarean section. There was no significant difference in pain, anxiety, satisfaction, and cooperation between the Xyla-P and lidocaine groups. However, in the group receiving lidocaine, satisfaction (P-value: 0.001) and cooperation (P-value: 0.019) improved significantly compared to the placebo group, whereas anxiety increased significantly compared to the placebo group (P-value: 0.045). Conclusions: Lidocaine had a positive effect on maternal satisfaction with spinal anesthesia and, compared to the placebo, led to significant improvements in maternal satisfaction and cooperation. In light of these findings, lidocaine emerges as a more appropriate choice than Xyla-P cream.