Khan Masood A, Beyzade Bengi, Tau William, Virdi Jaspal S, Potluri Bernard S
Department of Urology, Princess Alexandra Hospital, Harlow, Essex, UK.
Urol Int. 2002;68(3):164-7. doi: 10.1159/000048443.
Flexible cystoscopy is commonly performed under local anaesthesia. Instillation of lignocaine gel is commonly associated with urethral discomfort, which in some cases results in fierce opposition to further flexible cystoscopy under local anaesthesia. Although studies have demonstrated that the temperature of lignocaine can influence the level of discomfort experienced, to date no study has investigated the influence of the rate of lignocaine delivery on perceived discomfort. We therefore performed a prospective, randomised study to investigate this in patients undergoing flexible cystoscopy. One hundred consenting men were randomised to receive 11 ml of 2% lignocaine hydrochloride gel over either 2 or 10 s. The groups were well matched for age. After instillation of the gel, the patients were immediately asked to score their discomfort using a visual analogue scale. The discomfort experienced by patients that received the gel over 10 s was significantly (p < 0.05; Student's t test) less than those that received it over 2 s. This was irrelevant of the age of the patient and the number of previous cystoscopies performed. We have demonstrated that slow administration results in decreased discomfort. This may, in turn, reduce the need to resort to general anaesthesia, which is associated with increased morbidity and cost.
软性膀胱镜检查通常在局部麻醉下进行。利多卡因凝胶的灌注通常会引起尿道不适，在某些情况下，这会导致患者强烈反对在局部麻醉下进一步进行软性膀胱镜检查。尽管研究表明利多卡因的温度会影响不适程度，但迄今为止，尚无研究调查利多卡因给药速度对感知不适的影响。因此，我们进行了一项前瞻性随机研究，以在接受软性膀胱镜检查的患者中对此进行调查。一百名同意参与的男性被随机分为两组，分别在2秒或10秒内接受11毫升2%的盐酸利多卡因凝胶。两组在年龄方面匹配良好。凝胶灌注后，立即要求患者使用视觉模拟量表对其不适程度进行评分。在10秒内接受凝胶的患者所经历的不适明显（p < 0.05；学生t检验）低于在2秒内接受凝胶的患者。这与患者的年龄和之前进行膀胱镜检查的次数无关。我们已经证明缓慢给药会减少不适。这反过来可能会减少采用全身麻醉的必要性，全身麻醉会增加发病率和成本。
