Obstetric and Gynecological Nursing - The Carter Center

4. Lateral: The incision is begun one or more in distant from
the condomned.
Disadvantages
- Bartholins duct may be served
- The levatorani muscle is weakened
- Bleeding is more profuse
- Suturing is more difficult
- The woman experiences subsequent discomfort
Local analgesia for Episotomy
Lignocaine /lidocaine/ 0.5 percent of 10ml is safe and efficient.
It takes effect rapidly with in 1 & 2 minutes.
Timing the incision
1. The head should be well down on the perineum, low
enough to keep it stretched and thinned
2. In breech presentation the posterior buttock would be
distending the perineum
3. It must be made neither too soon nor too late
Making the incision
1. Avoid incision on the previous episiotomy scar
2. Not more than 3 cm from fourchette and 2.5 cm from anus
3. Position the mother in lithotomy
4. Wait one or two minutes after injection of local anesthesia
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