Brekkan E, Ehrnebo M, Malmström P U, Norlén B J, Wirbrant A
Department of Urology, University Hospital, Uppsala, Sweden.
J Urol. 1991 Jul;146(1):24-7. doi: 10.1016/s0022-5347(17)37705-4.
To evaluate the influence of the volume of 2% lidocaine jelly as an anesthetic during cystoscopy 241 men and women received either 11 or 20 ml. jelly intraurethrally in a randomized, double-blind fashion. Pain was recorded on a visual analogue scale by the patient and on a 3-level scale by the physician. The pain scores according to the visual analogue scale were significantly higher in the patients given 11 ml. jelly than in those given 20 ml. when all patients in the study were analyzed. There was no significant difference in the visual analogue scale between the 2 treatments in women but a significant difference was noted in men, although in men older than 55 years the difference was not statistically significant. There was general agreement between the visual analogue scale results and the physician scores but the visual analogue scale procedure was more sensitive in detecting differences between treatments. It is suggested that approximately 11 ml. 2% lidocaine jelly is the appropriate volume for women and 20 ml. is the appropriate volume for men during cystoscopy but that the lower volume of jelly may be sufficient in older men.
为评估2%利多卡因凝胶作为膀胱镜检查麻醉剂时的用量影响，241名男性和女性以随机、双盲方式经尿道分别接受11毫升或20毫升凝胶。患者通过视觉模拟评分法记录疼痛，医生通过三级评分法记录疼痛。对研究中的所有患者进行分析时，接受11毫升凝胶的患者根据视觉模拟评分法得出的疼痛评分显著高于接受20毫升凝胶的患者。两种治疗方法在女性患者的视觉模拟评分上无显著差异，但在男性患者中有显著差异，不过55岁以上男性患者的差异无统计学意义。视觉模拟评分结果与医生评分基本一致，但视觉模拟评分法在检测不同治疗方法之间的差异时更敏感。建议在膀胱镜检查时，女性使用约11毫升2%利多卡因凝胶为宜，男性使用20毫升为宜，但老年男性使用较低剂量的凝胶可能就足够了。
