Less Painful Alternatives for Local Anesthesia

Lugo‐Janer, Gerardo; Padial, Michael; Sánchez, Jorge

doi:10.1111/j.1524-4725.1993.tb00342.x

Cited by 41 publications

(22 citation statements)

References 8 publications

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“…A significance decrease in pain has also been reported when using a cooled lidocaine gel but this method have not reached widespread acceptance in the urological community [11]. On the other hand, the administration of local anesthetic agents can cause pain in itself [12,13]. In support of this, it has been reported that the delivery of lidocaine gel may cause more discomfort than plain gel.…”

Section: Discussionsupporting

confidence: 51%

Prior Lubrication of the Urethra Does Not Reduce Pain Perception in Men Undergoing Flexible Cystoscopy

Carrión¹,

Garcı́a-Cruz²,

Fernández³

et al. 2016

Urol Int

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Objective: The study aimed to test the hypothesis that the instillation of lidocaine gel does not reduce the pain related to flexible cystoscopy. Material and Methods: A prospective randomized study was designed to compare the pain perception between intraurethral instillation of lidocaine gel and saline solution in flexible cystoscopy. One hundred consecutive male patients attending for flexible cystoscopy were randomized to receive 10 ml of lidocaine gel or 10 ml of saline solution. Saline solution was also used for the irrigation pressure. Patients recorded their pain on a 10 cm Visual Analog Scale before and after the procedure. Patients also assessed whether the cystoscopy was more painful than the previous one. Statistical comparison was made using the t test for parametrical data and the Mann-Whitney U test for non-parametrical data. Results: Mean pain score in the lidocaine group was 0.67 ± 1.11 cm (range 0-5) compared to 0.55 ± 1.10 cm (range 0-5) in the saline solution group. Pain perception did not differ significantly between the 2 groups (mean difference 0.12 cm, 95% CI -0.32 to 0.55, p = 0.40). Conclusions: Prior lubrication of the urethra does not reduce the pain produced during flexible cystoscopy. The introduction of flexible cystoscopes under direct vision and with an irrigation pressure might guarantee sufficient comfort and the lubricant gel instillation could be avoided.

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Section: Discussionsupporting

confidence: 51%

Prior Lubrication of the Urethra Does Not Reduce Pain Perception in Men Undergoing Flexible Cystoscopy

Carrión¹,

Garcı́a-Cruz²,

Fernández³

et al. 2016

Urol Int

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“…Unfortunately the anaesthesia is only of very short duration, approximately 2–5 min. This can be prolonged by the use of adrenaline admixture with minimal effect on the pain of infiltration 11 . Unfortunately bacteriostatic saline is not available in Australia.…”

Section: Discussionmentioning

confidence: 99%

“…The onset, duration and quality of the block do not appear to be affected adversely by buffering. Some of the studies assessed this directly by timing for the onset and duration of anaesthesia 5,7,11 . Anaesthesia was usually checked for by loss of pinprick sensation or cold sensation with alcohol swabs.…”

Section: Discussionmentioning

confidence: 99%

Buffering the pain of local anaesthetics: A systematic review

Davies

2003

Emergency Medicine

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Objective: To review the evidence that buffering of local anaesthetics with sodium bicarbonate reduces the pain of injection whilst not affecting efficacy. Methods: Medline search from 1966 to December 2001. Articles in all languages were included. Bibliographies were examined for papers. Results: The search identified 63 publications. All were retrieved. Of these, 22 were human prospective randomized controlled trials directly assessing the pain of infiltration. Three papers were based on observations. No case series, case reports, or retrospective studies were identified. One animal study was found. Conclusion: The evidence is that buffering with sodium bicarbonate significantly reduces the pain of local anaesthetic injection. The buffered solutions retain the efficacy of local anaesthetics and are stable in the mixtures used in the trials. Adrenaline‐containing buffered solutions need refrigeration in closed containers for storage. Buffering will be particularly useful where pain of local anaesthetic injection may not be well tolerated such as in large areas of infiltration, sensitive areas such as the face and in children. It is recommended that sodium bicarbonate and tables of stable dilutions are readily available in the emergency department to facilitate this.

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“…41 Several studies examined strategies to overcome discomfort during urethral instillation to increase clinical effectiveness of lidocaine gel.…”

Section: Improving Factorsmentioning

confidence: 99%

Intraurethral Lubricants: A Critical Literature Review and Recommendations

Tzortzis

Gravas

Melekos

et al. 2009

Journal of Endourology

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In current clinical practice, lidocaine gel is widely used as a local anesthetic lubricant before various forms of transurethral instrumentation. Over the past few years, the value of local anesthesia during urethral catheterization and flexible or rigid cystoscopy has been questioned. Strong data are lacking, and the results from the different studies are contradictory. As a result, the correct use of the intraurethral gels is, for the most part, left to individual preference. The purpose of this review is to provide an overview of the characteristics of the intraurethral gels, to assess the effectiveness, and to define evidence-based indications for their use.

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Less Painful Alternatives for Local Anesthesia

Cited by 41 publications

References 8 publications

Prior Lubrication of the Urethra Does Not Reduce Pain Perception in Men Undergoing Flexible Cystoscopy

Prior Lubrication of the Urethra Does Not Reduce Pain Perception in Men Undergoing Flexible Cystoscopy

Buffering the pain of local anaesthetics: A systematic review

Intraurethral Lubricants: A Critical Literature Review and Recommendations

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