The impact of a topical spray of lidocaine 10% on maternal satisfaction prior to spinal needle insertion for cesarean delivery in North India: a prospective, randomized, double-blind, placebo-controlled trial

Background: Maternal satisfaction with anesthesia services is crucial, and an important factor affecting it is spinal needle pain. This study was designed to ascertain the effects of a topical spray of 10% lidocaine on spinal needle prick pain and its correlation with maternal satisfaction.Methods: One hundred ten patients receiving subarachnoid blockade prior to cesarean delivery were randomly allocated to two groups: group LIDO (2 puffs of topical 10% lidocaine spray) and group NS (2 puffs of normal saline spray) given 120 s prior to lumbar puncture, and finally data from 99 patients was analyzed. The primary outcome was maternal satisfaction score (1–5) at the end of surgery, and secondary outcomes were numeric rating scale (NRS) pain score during spinal needle puncture, physical response to pain (observer-assessed score, 0–4).Results: Maternal satisfaction did not differ significantly between the two groups (mean rank 50.76 vs. 49.26; median 1Q, 3Q: 4 4, 5 vs. 4 4, 5, P = 0.767). Although both the NRS score and the physical response to spinal needle prick were significantly lower in the LIDO group compared to placebo (P < 0.001 for both), maternal satisfaction remained comparable between the groups.Conclusions: Topical 10% lidocaine spray is a feasible, economic, and effective intervention to alleviate pain during spinal needle prick in pregnant women. However, addressing spinal needle prick pain alone cannot improve maternal satisfaction and requires a multidimensional approach.