Comparison between cooled and room temperature lidocaine gel in reducing urethral discomfort during cystoscopy

  • Thongchai Chansirirattanakul Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Tanet Thaidumrong Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Vorapot Choonhaklai Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Viroj Chittchang Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Somkiat Pumpaisanchai Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Nattapong Wongwattanasatien Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Sermsin Sindhubodee Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Chawawat Kosrisirikul Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Matchima Huabkong Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Somjith Duangkae Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
Keywords: lignocaine gel, cystoscopy

Abstract

Objective:  Prospective randomized control trial study to compare pain score between room temperature and cooled 2% lidocaine gel during instillation and cystoscopy

Material and method:  Male patients who had indication for cystoscopy  between September 2017  and December  2017 at Rajavithi hospital were included in this study . They were  prospectively randomized into 2 groups .Group I  receive 10 ml of  2% lidocaine hydrochloride gel at 4 ◦C and Group II receive 10 ml of  2% lidocaine hydrochloride gel at room temperature (22 ◦C). After instillations of the gel and at the end of cystoscopy the patients were immediately asked to score the pain level using a NUMERIC RATING SCALE (NRS) FOR PAIN

Result: A total of 70 male patients were enrolled in the study then were randomized into 2 groups . No significant differences in patient age and numbers of previous cystoscopy between the two groups . The pain scores were analyzed using the Mann-Whitney U test. Pain perception scores during gel instillation were not statistically different between the groups ( P= 0.496 ). Pain perception scores during cystoscopic procedure in group I were statistically lower than in group II (P < 0.05) 

Conclusion: Transurethral cooled  2% lidocaine gel significantly reduced the pain during cystoscopy  when compare  with instillation of  room temperature 2% lidocaine hydrochloride .But did not significantly reduce pain perception score during gel instillation

Downloads

Download data is not yet available.

References

1. Goel R, Aron M. Cooled lignocaine gel: does it reduce urethral discomfort during instillation? International urology and nephrology. 2003;35(3):375-7.
2. Yoshimura R, Wada S, Kishimoto T. Why the flexible cystoscope has not yet been widely introduce?: a questionnaire to Japanese urologists. Int. J. Urol. 1999; 6: 549-59.
3. Muezzinoglu T, Ceylan Y, Temeltas G, Lekili M, Buyuksu C. Evaluation of pain caused by urethrocystoscopy in patients with superficial bladder cancer: a perspective of quality of life. Onkologie 2005; 28: 260-4.
4. Taghizadeh AK, El Madani A, Gard PR, Li CY, Thomas PJ, Denyer SP. When does it hurt? Pain during flexible cystoscopy in men. Urol. Int. 2006; 76: 301-3.
5. Choong S, Whitfield HN, Meganathan V et al. A prospective, randomized, double-blind study comparing lignocaine gel
and plain lubricating gel in relieving pain during flexible cystoscopy. Br J Urol 1997; 80: 69–71.
6. Gordh T. Xylocaine: a new local analgesic. Anaesthesia 1949; 4: 4–9
7. Rogers HJ, Spector RG, Trounce JR. Local anaesthetics. In Rogers HJ, Spector RG, Trounce JR, eds, A Textbook of Clincal Pharmacology, 1st edn, Chapt 11, London: Hodder and Stoughton, 1985: 343–4
8. Khan MA, Beyzade B, Tau W et al. Effect of the rate of delivery of lignocaine gel on patient discomfort perception prior to performing flexible cystoscopy. Urol Int 2002; 68: 164–167.
9. Burke D, Mogyoros I, Vagg R, Kiernan MC. Temperature dependence of excitability indices of human cutaneous afferents. Muscle Nerve 1999; 22: 51–60
10. Thompson TJ, Thompson N, O’Brien A et al. To determine whether the temperature of 2%lignocaine gel affects the initial discomfort which may be associated with its instillation into the male urethra. BJU Int 1999; 84: 1035–1037
11. Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J. Clin. Nurs. 2005; 14: 798-804.
Published
2018-12-05
How to Cite
Chansirirattanakul, T., Thaidumrong, T., Choonhaklai, V., Chittchang, V., Pumpaisanchai, S., Wongwattanasatien, N., Sindhubodee, S., Kosrisirikul, C., Huabkong, M., & Duangkae, S. (2018). Comparison between cooled and room temperature lidocaine gel in reducing urethral discomfort during cystoscopy. The Thai Journal of Urology, 39(2), 28-34. Retrieved from https://he02.tci-thaijo.org/index.php/TJU/article/view/115049
Section
Original article

Most read articles by the same author(s)