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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
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.