{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:22:57Z","timestamp":1791901377233,"version":"4.3.4"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Perineal lacerations are a very common complication of post-partum. Usually, the repair of 1st and 2nd-grade lacerations is performed after the administration of local anesthesia. Despite the great relevance of the problem, there are only a few studies about the best choice of local anesthetic to use during suturing. We performed a randomised controlled trial to evaluate the efficacy and safety of the use of a local anesthetic spray during the suturing of perineal lacerations in the post-partum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared the spray with the standard technique, which involves the infiltration of lacerated tissues, using the NRS scale. 136 eligible women who had given birth at University Hospital of Udine were enrolled and randomly assigned to receive nebulization of Lidocaine hydrochloride 10% spray (experimental group) or subcutaneous\/submucosal infiltration of mepivacaine hydrochloride (control group) during suturing of perineal laceration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The lacerations included 84 1st-grade perineal traumas (61.7%) and 52 2nd-grade perineal traumas (38.2%). All the procedures were successfully completed without severe complications or serious adverse reactions. There were no statistically significant differences between the two groups in terms of blood losses or total procedure time. Moreover, there were no statistically significant differences in terms of NRS to none of the intervals considered. Regarding the application of the spray in the B group, in 36 cases (52.9%) it was necessary to improve the number of puffs previously supposed to be sufficient (5 puffs). Just in 3 cases, an additional injection was necessary (4.4%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study demonstrates that lidocaine spray alone can be used as a first line of local anesthetic during the closure of I-II-grade perineal lacerations, as it has comparable efficacy to mepivacaine infiltration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      The trial was recorded on\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\">https:\/\/clinicaltrials.gov<\/jats:ext-link>\n                      . Identification number: NCT05201313. First registration date: 21\/01\/2022. Unique Protocol ID: 0042698\/P\/GEN\/ARCS.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12884-024-06640-7","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T04:02:45Z","timestamp":1719201765000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Lidocaine spray vs mepivacaine local infiltration for suturing 1st\/2nd grade perineal lacerations: a randomised controlled non-inferiority trial"],"prefix":"10.1186","volume":"24","author":[{"given":"Stefano","family":"Restaino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matilde","family":"Degano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Rizzante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ginevra","family":"Battello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Paparcura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Biasioli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Arcieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Filip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Vetrugno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Dogareschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Bove","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Petrillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giampiero","family":"Capobianco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Vizzielli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenza","family":"Driul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"LISPRAY Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana","family":"Moroni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Zanin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Tius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Celante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Sala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Poli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Pregnolato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina","family":"Seminara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Cuman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Pellecchia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Occhiali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Giorgiutti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Liviero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Mazzera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Padovani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"De Gennaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,24]]},"reference":[{"key":"6640_CR1","doi-asserted-by":"publisher","first-page":"35","DOI":"10.31128\/AFP-09-17-4333","volume":"47","author":"R Goh","year":"2018","unstructured":"Goh R, Goh D, Ellepola H. Perineal tears \u2013 a review. Aust J Gen Pract. 2018;47:35\u20138.","journal-title":"Aust J Gen Pract"},{"key":"6640_CR2","unstructured":"Haupt BJ, Jones A. The National Home and Hospice Care Survey: 1996 summary. Vital Health Stat 13. 1999;(141):1-238. PMID: 10549237."},{"key":"6640_CR3","doi-asserted-by":"publisher","unstructured":"NHS Maternity Services London. Department of Health. Statistical bulletin. Ann Tour Res. 2003. https:\/\/doi.org\/10.1016\/0160-7383(78)90182-2.","DOI":"10.1016\/0160-7383(78)90182-2"},{"key":"6640_CR4","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1046\/j.1523-536X.2002.00173.x","volume":"29","author":"DA Webb","year":"2002","unstructured":"Webb DA, Culhane J. Hospital variation in episiotomy use and the risk of perineal trauma during childbirth. Birth. 2002;29:132\u20136. https:\/\/doi.org\/10.1046\/j.1523-536X.2002.00173.x.","journal-title":"Birth"},{"key":"6640_CR5","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1177\/135626229900500601","volume":"5","author":"AH Sultan","year":"1999","unstructured":"Sultan AH. Editorial: obstetrical perineal injury and anal incontinence. Clin Risk. 1999;5:193\u20136. https:\/\/doi.org\/10.1177\/135626229900500601.","journal-title":"Clin Risk"},{"key":"6640_CR6","volume-title":"Management of Third and Fourth-degree Perineal Tears. Royal College of Obstetricians and Gynaecologists - Green-top Guideline No. 29","author":"RJ Fernando","year":"2015","unstructured":"Fernando RJ, Sultan AH, Freeman RM, Williams AA, Adams EJ. Management of Third and Fourth-degree Perineal Tears. Royal College of Obstetricians and Gynaecologists - Green-top Guideline No. 29. 2015."},{"key":"6640_CR7","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.midw.2006.12.006","volume":"25","author":"PM Colacioppo","year":"2009","unstructured":"Colacioppo PM, Gonzalez Riesco ML. Effectiveness of local anesthetics with and without vasoconstrictors for perineal repair during spontaneous delivery: double-blind randomised controlled trial. Midwifery. 2009;25:88\u201395. https:\/\/doi.org\/10.1016\/j.midw.2006.12.006.","journal-title":"Midwifery"},{"key":"6640_CR8","doi-asserted-by":"publisher","first-page":"186.e1","DOI":"10.1016\/j.ajog.2009.04.023","volume":"201","author":"M Franchi","year":"2009","unstructured":"Franchi M, Cromi A, Scarperi S, Gaudino F, Siesto G, Ghezzi F. Comparison between lidocaine-prilocaine cream (EMLA) and mepivacaine infiltration for pain relief during perineal repair after childbirth: a randomized trial. Am J Obstet Gynecol. 2009;201:186.e1-186.e5. https:\/\/doi.org\/10.1016\/j.ajog.2009.04.023.","journal-title":"Am J Obstet Gynecol"},{"key":"6640_CR9","doi-asserted-by":"publisher","first-page":"809","DOI":"10.3109\/00016349409072510","volume":"73","author":"M Van Der Burght","year":"1994","unstructured":"Van Der Burght M, Sch\u00f8nemann NK, Laursen JK, Arendt-nielsen L, Bjerring P. Onset and duration of hypoalgesia following application of lidocaine spray on genital mucosa. Acta Obstet Gynecol Scand. 1994;73:809\u201311. https:\/\/doi.org\/10.3109\/00016349409072510.","journal-title":"Acta Obstet Gynecol Scand"},{"key":"6640_CR10","first-page":"1","volume-title":"Lidocaina cloridrato S.A.L.F. 10 mg\/ml soluzione iniettabile","author":"Agenzia Italiana del Farmaco GU della RI","year":"2018","unstructured":"Agenzia Italiana del Farmaco GU della RI. Lidocaina cloridrato S.A.L.F. 10 mg\/ml soluzione iniettabile. 2018. p. 1\u20139."},{"key":"6640_CR11","unstructured":"Ecocain. SRL Molteni Dental. GU II N\u00b0 202. 2005. https:\/\/farmaci.agenziafarmaco.gov.it\/aifa\/servlet\/PdfDownloadServlet?pdfFileName=footer_000853_027388_RCP.pdf&sys=m0b1l3."},{"key":"6640_CR12","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1136\/jfprhc-2014-100917","volume":"42","author":"H Aksoy","year":"2016","unstructured":"Aksoy H, Aksoy \u00dc, Ozyurt S, A\u00e7maz G, Babayigit M. Lidocaine 10% spray to the cervix reduces pain during intrauterine device insertion: a double-blind randomised controlled trial. J Fam Plan Reprod Heal Care. 2016;42:83\u20137. https:\/\/doi.org\/10.1136\/jfprhc-2014-100917.","journal-title":"J Fam Plan Reprod Heal Care"},{"key":"6640_CR13","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1186\/s12884-022-04912-8","volume":"22","author":"X Ran","year":"2022","unstructured":"Ran X, Zhou S, Cao K, et al. Optimization of programmed intermittent epidural bolus volume for different concentrations of ropivacaine in labor analgesia: a biased coin up-and-down sequential allocation trial. BMC Pregnancy Childbirth. 2022;22:590. https:\/\/doi.org\/10.1186\/s12884-022-04912-8.","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"6640_CR14","doi-asserted-by":"publisher","first-page":"25","DOI":"10.2478\/rjaic-2019-0004","volume":"26","author":"OV Riazanova","year":"2019","unstructured":"Riazanova OV, Alexandrovich YS, Guseva YV, Ioscovich AM. A randomized comparison of low dose ropivacaine programmed intermittent epidural bolus with continuous epidural infusion for labour analgesia. Rom J Anaesth Intensive Care. 2019;26(1):25\u201330. https:\/\/doi.org\/10.2478\/rjaic-2019-0004. PMID:31111092;PMCID:PMC6502272.","journal-title":"Rom J Anaesth Intensive Care"},{"issue":"2","key":"6640_CR15","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.bjae.2019.10.002","volume":"20","author":"A Taylor","year":"2020","unstructured":"Taylor A, McLeod G. Basic pharmacology of local anaesthetics. BJA Educ. 2020;20(2):34\u201341. https:\/\/doi.org\/10.1016\/j.bjae.2019.10.002. Epub 2019 Dec 4. Erratum in: BJA Educ. 2020;20(4):140. PMID: 33456928; PMCID: PMC7808030.","journal-title":"BJA Educ"},{"key":"6640_CR16","volume-title":"Mepivacaina Cloridrato soluzione iniettabile","author":"Agenzia Italiana del Farmaco GU della RI","year":"2021","unstructured":"Agenzia Italiana del Farmaco GU della RI. Mepivacaina Cloridrato soluzione iniettabile. 2021."},{"issue":"5","key":"6640_CR17","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1016\/j.contraception.2020.07.002","volume":"102","author":"R Meyer","year":"2020","unstructured":"Meyer R, Cahan T, Yagel I, et al. A double-blind randomized trial comparing lidocaine spray and placebo spray anesthesia prior to cervical laminaria insertion. Contraception. 2020;102(5):332\u20138. https:\/\/doi.org\/10.1016\/j.contraception.2020.07.002.","journal-title":"Contraception"},{"issue":"3","key":"6640_CR18","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1136\/bmjsrh-2020-200670","volume":"47","author":"N Panichyawat","year":"2021","unstructured":"Panichyawat N, Mongkornthong T, Wongwananuruk T, Sirimai K. 10% lidocaine spray for pain control during intrauterine device insertion: a randomised, double-blind, placebo-controlled trial. BMJ Sex Reprod Health. 2021;47(3):159\u201365. https:\/\/doi.org\/10.1136\/bmjsrh-2020-200670. Epub 2020 Jun 26.","journal-title":"BMJ Sex Reprod Health"},{"issue":"10","key":"6640_CR19","doi-asserted-by":"publisher","first-page":"2399","DOI":"10.1016\/j.pain.2011.07.005","volume":"152","author":"MA Ferreira-Valente","year":"2011","unstructured":"Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152(10):2399\u2013404. https:\/\/doi.org\/10.1016\/j.pain.2011.07.005.","journal-title":"Pain"},{"issue":"2","key":"6640_CR20","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1097\/SLA.0b013e3181b13ca2","volume":"250","author":"PA Clavien","year":"2009","unstructured":"Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications. Ann Surg. 2009;250(2):187\u201396. https:\/\/doi.org\/10.1097\/SLA.0b013e3181b13ca2.","journal-title":"Ann Surg"},{"key":"6640_CR21","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1016\/S0196-0644(96)70238-X","volume":"27","author":"KH Todd","year":"1996","unstructured":"Todd KH, Funk KG, Funk JP, Bonacci R. Clinical significance of reported changes in pain severity. Ann Emerg Med. 1996;27:485\u20139.","journal-title":"Ann Emerg Med"},{"key":"6640_CR22","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1136\/emj.18.3.205","volume":"18","author":"A Kelly","year":"2001","unstructured":"Kelly A. The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emerg Med J. 2001;18:205\u20137.","journal-title":"Emerg Med J"},{"key":"6640_CR23","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1111\/jog.14152","volume":"46","author":"K Charoenkwan","year":"2020","unstructured":"Charoenkwan K, Nantasupha C. Methods of pain control during endometrial biopsy: a systematic review and meta-analysis of randomized controlled trials. J Obstet Gynaecol Res. 2020;46:9\u201330. https:\/\/doi.org\/10.1111\/jog.14152.","journal-title":"J Obstet Gynaecol Res"},{"key":"6640_CR24","doi-asserted-by":"publisher","first-page":"2161","DOI":"10.1097\/PRS.0b013e318170a7a4","volume":"121","author":"S Kaweski","year":"2008","unstructured":"Kaweski S. Topical anesthetic creams. Plast Reconstr Surg. 2008;121:2161\u20135. https:\/\/doi.org\/10.1097\/PRS.0b013e318170a7a4.","journal-title":"Plast Reconstr Surg"},{"key":"6640_CR25","doi-asserted-by":"publisher","unstructured":"Lander JA, Weltman BJ, So SS, Hobson A. EMLA and Amethocaine for reduction of children\u2019s pain associated with needle insertion. Cochrane Database Syst Rev. 2014. https:\/\/doi.org\/10.1002\/14651858.CD004236.pub3.","DOI":"10.1002\/14651858.CD004236.pub3"},{"key":"6640_CR26","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1111\/j.1524-4725.2007.33221.x","volume":"33","author":"TS Alster","year":"2007","unstructured":"Alster TS. The lidocaine\/tetracaine peel: a novel topical anesthetic for dermatologic procedures in adult patients. Dermatologic Surg. 2007;33:1073\u201381. https:\/\/doi.org\/10.1111\/j.1524-4725.2007.33221.x.","journal-title":"Dermatologic Surg"},{"key":"6640_CR27","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1089\/end.2005.19.738","volume":"19","author":"AB Galosi","year":"2005","unstructured":"Galosi AB, Minardi D, Dell\u2019Atti L, Yehia M, Muzzonigro G. Tolerability of prostate transrectal biopsies using gel and local anesthetics: results of a randomized clinical trial. J Endourol. 2005;19:738\u201343. https:\/\/doi.org\/10.1089\/end.2005.19.738.","journal-title":"J Endourol"},{"key":"6640_CR28","first-page":"32","volume":"44","author":"ER Vickers","year":"1997","unstructured":"Vickers ER, Marzbani N, Gerzina TM, McLean C, Punnia-Moorthy A, Mather L. Pharmacokinetics of EMLA cream 5% application to oral mucosa. Anesth Prog. 1997;44:32\u20137.","journal-title":"Anesth Prog"},{"key":"6640_CR29","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1046\/j.1523-536x.2001.00022.x","volume":"28","author":"A Corkill","year":"2001","unstructured":"Corkill A, Lavender T, Walkinshaw SA, Alfirevic Z. Reducing postnatal pain from perineal tears by using lignocaine gel: a double-blind randomized trial. Birth. 2001;28:22\u20137. https:\/\/doi.org\/10.1046\/j.1523-536x.2001.00022.x.","journal-title":"Birth"},{"key":"6640_CR30","doi-asserted-by":"publisher","unstructured":"Hedayati H, Parsons J, Crowther CA. Topically applied anaesthetics for treating perineal pain after childbirth. Cochrane Database Syst Rev. 2005. https:\/\/doi.org\/10.1002\/14651858.cd004223.pub2.","DOI":"10.1002\/14651858.cd004223.pub2"},{"key":"6640_CR31","doi-asserted-by":"publisher","first-page":"51S","DOI":"10.1097\/00006250-200204001-00112","volume":"99","author":"VA Minassian","year":"2002","unstructured":"Minassian VA, Prien SD, Jazayeri A, Timmons R. Lidocaine ointment versus placebo for the treatment of episiotomy or postpartum perineal laceration pain. Obstet Gynecol. 2002;99:51S. https:\/\/doi.org\/10.1097\/00006250-200204001-00112.","journal-title":"Obstet Gynecol"},{"key":"6640_CR32","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/S0020-7292(02)00103-0","volume":"78","author":"B Se\u00e7kin","year":"2002","unstructured":"Se\u00e7kin B, Av\u015far F, Parlakyiit EE, Aksakal O. Effects of indomethacin suppository and lidocaine pomade for the relief of post-episiotomy pain. Int J Gynecol Obstet. 2002;78:159\u201361. https:\/\/doi.org\/10.1016\/S0020-7292(02)00103-0.","journal-title":"Int J Gynecol Obstet"},{"key":"6640_CR33","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1097\/LGT.0000000000000099","volume":"19","author":"M \u00d6z","year":"2015","unstructured":"\u00d6z M, Korkmaz E, Cetinkaya N, Ba\u015f S, \u00d6zdal B, Meydanli MM, et al. Comparison of topical lidocaine spray with placebo for pain relief in colposcopic procedures: a randomized placebo-controlled, double-blind study. J Low Genit Tract Dis. 2015;19:212\u20134. https:\/\/doi.org\/10.1097\/LGT.0000000000000099.","journal-title":"J Low Genit Tract Dis"},{"key":"6640_CR34","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1016\/S0029-7844(00)00984-4","volume":"96","author":"D Soriano","year":"2000","unstructured":"Soriano D, Ajaj S, Chuong T, Deval B, Fauconnier A, Dara\u00ef E. Lidocaine spray and outpatient hysteroscopy: randomized placebo-controlled trial. Obstet Gynecol. 2000;96:661\u20134. https:\/\/doi.org\/10.1016\/S0029-7844(00)00984-4.","journal-title":"Obstet Gynecol"},{"key":"6640_CR35","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1111\/jog.13932","volume":"45","author":"R Piyawetchakarn","year":"2019","unstructured":"Piyawetchakarn R, Charoenkwan K. Effects of lidocaine spray for reducing pain during endometrial aspiration biopsy: a randomized controlled trial. J Obstet Gynaecol Res. 2019;45:987\u201393. https:\/\/doi.org\/10.1111\/jog.13932.","journal-title":"J Obstet Gynaecol Res"},{"key":"6640_CR36","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1016\/j.midw.2004.12.003","volume":"21","author":"J Sanders","year":"2005","unstructured":"Sanders J, Peters TJ, Campbell R. Techniques to reduce perineal pain during spontaneous vaginal delivery and perineal suturing: a UK survey of midwifery practice. Midwifery. 2005;21:154\u201360. https:\/\/doi.org\/10.1016\/j.midw.2004.12.003.","journal-title":"Midwifery"},{"key":"6640_CR37","doi-asserted-by":"publisher","unstructured":"Aasheim V, Nilsen ABV, Reinar LM, Lukasse M. Perineal techniques during the second stage of labour for reducing perineal trauma. Cochrane Database Syst Rev. 2017. https:\/\/doi.org\/10.1002\/14651858.CD006672.pub3.","DOI":"10.1002\/14651858.CD006672.pub3"},{"issue":"6","key":"6640_CR38","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1080\/14767058.2018.1512574","volume":"33","author":"CI Aquino","year":"2020","unstructured":"Aquino CI, Guida M, Saccone G, Cruz Y, Vitagliano A, Zullo F, Berghella V. Perineal massage during labor: a systematic review and meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med. 2020;33(6):1051\u201363. https:\/\/doi.org\/10.1080\/14767058.2018.1512574.","journal-title":"J Matern Fetal Neonatal Med"}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-024-06640-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12884-024-06640-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-024-06640-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T04:03:56Z","timestamp":1719201836000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-024-06640-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,24]]},"references-count":38,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["6640"],"URL":"https:\/\/doi.org\/10.1186\/s12884-024-06640-7","relation":{},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,24]]},"assertion":[{"value":"9 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The trial was conducted after approval from the Regional Ethics Committee (CEUR-2021-Sper-136). Written informed consent was requested for all the recruited women.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"439"}}