To determine whether the temperature of 2% lignocaine gel affects the initial discomfort which may be associated with its instillation into the male urethra

Abstract

Objective To determine whether the temperature of 2%Results Compared with the control group (at 22°C), there was a statistically significant reduction in pain lignocaine hydrochloride gel aCects the initial discomfort during instillation into the male urethra. score in the group receiving cold gel (Student's t-test, P<0.05). Patients and methods Sixty consenting men were randomized to receive 11 mL of 2% lignocaine hydroConclusion The cooling of 2% lignocaine gel significantly reduced the initial discomfort associated with chloride gel (Instillagel, Farco-Pharma GmbH, Cologne, Germany) at 4°C, 22°C or 40°C. The three its delivery into the male urethra before any form of urethral instrumentation. groups were well matched for age and numbers of previous flexible cystoscopies. The gel was instilled byKeywords Topical lignocaine gel, urethra, local anaesthesia one operator and the patients were then immediately asked to score the pain on instillation using a 100-mm nongraphical visual analogue scale.men were recruited and randomized to receive 11 mL of

Music Reduces Panic: An Initial Study of Listening to Preferred Music Improves Male Patient Discomfort and Anxiety During Flexible Cystoscopy

“…So many studies had examined different methods to reduce male patients' discomfort, such as assessment of the volume of lidocaine, 10 increasing hydrostatic pressure by squeezing the irrigation solution bag, 11 cooled lignocaine gel, 12 simultaneous visualization, 13 application of nitrous oxide inhalation, 14 slow delivery of local anesthetics, 15 use of 740 ZHANG ET AL.…”

2% Lidocaine gel or plain lubricating gel: Which one should be used in male flexible cystoscopy?

“…We slowly delivered intraurethral lidocaine and plain lubricating gel in all patients. Thomson, Goel et al [22,23] reported that cooling the lidocaine gel to 4°C significantly reduced the discomfort compared to the same agent at 22°C. However, Bhomi et al [2] reported cooled lidocaine gel at 4°C has no advantage over room temperature lidocaine gel for decreasing pain perception during rigid cystoscopy.…”

Effect of the Rate of Delivery of Lignocaine Gel on Patient Discomfort Perception prior to Performing Flexible Cystoscopy

“…It is a lipid soluble amide base that is capable of entering the hydrophobic components of neuronal cell membranes and preventing the transmembrane flow of sodium ions necessary for the initiation and propagation of nerve signal action potentials [3,6]. It is usually marketed as its hydrochloride salt, with a pH of 4-6 to increase both the solubility and shelf-life [3,7].…”

“…To this effect, over 30 years ago, Boggia [4] demonstrated that warming local anaesthetic agents results in decreased discomfort. Thompson et al [3], on the other hand, have recently demonstrated the opposite. They have shown, in a prospective, double-blind, randomised study that cooling of 2% lignocaine gel to 4°C, compared with 22°C (room temperature) or 40°C, significantly reduces the initial discomfort associated with its delivery into the male urethra [4].…”

“…Similarly, the intraurethral administration of 2% lignocaine hydrochloride gel can also be associated with initial considerable discomfort in many, if not all, male patients. Despite this painful paradox, the use of topical urethral anaesthetic, using 2% lignocaine hydrochloride gel, has become an accepted and almost unchallenged part of contemporary urological practice [2,3]. Histogram demonstrating that slow administration of lignocaine gel over 10 s (n = 52) is associated with significantly reduced patient discomfort compared with administration over 2 s (n = 48).…”