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女性患者尿动力学检查期间尿道内使用利多卡因:一项系统评价和荟萃分析。

Intraurethral lidocaine use during urodynamics in female patients: A systematic review and meta-analysis.

作者信息

Oktaviani Dian Paramita, Soebadi Mohammad Ayodhia, Kloping Yudhistira Pradnyan, Hidayatullah Furqan, Rahman Zakaria Aulia, Soetojo Soetojo

机构信息

Department of Urology, Universitas Airlangga Faculty of Medicine, Dr. Soetomo General- Academic Hospital, Surabaya, Indonesia.

Department of Urology, Universitas Airlangga Faculty of Medicine, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia.

出版信息

Turk J Urol. 2021 Sep;47(5):366-374. doi: 10.5152/tud.2021.21182.

Abstract

Pain and discomfort may occur in catheterization during a urodynamic examination. A lidocaine gel combined with a water-based lubricant is sometimes used to reduce pain during catheterization. Several studies claimed that intraurethral lidocaine administration could cause inaccurate urodynamic parameters results. However, its definite effects in urodynamics testing on humans are still not clear. We aimed to evaluate the effects of intraurethral lidocaine on pain and urodynamic study parameters in patients undergoing an invasive urodynamic examination. A systematic search adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was performed in the MEDLINE, PubMed, and ScienceDirect databases for randomized controlled trials (RCTs). The bias of the studies is evaluated using the Cochrane risk of bias tool by two independent reviewers. The analyses of continuous outcomes were displayed as mean difference (MD), whereas odds ratio is used to analyze dichotomous data. Heterogeneity between studies is determined using the I2 value. A total of three RCTs out of 622 discovered that articles were eligible for analysis. Forest plot analysis of the mean visual analogue scale difference of the studies indicated an insignificant difference between the lidocaine and placebo group (MD -7.68; 95% CI -34.04 to -18.68, P ¼ .57). All urodynamic parameter results were also similar between the two groups (P > .05). Routine intraurethral lidocaine injection prior to a urodynamic study does not affect pain intensity and urodynamic parameters.

摘要

在尿动力学检查期间进行导尿时可能会出现疼痛和不适。有时会使用利多卡因凝胶与水基润滑剂相结合来减轻导尿过程中的疼痛。几项研究称,尿道内给予利多卡因可能会导致尿动力学参数结果不准确。然而,其在人体尿动力学测试中的明确效果仍不清楚。我们旨在评估尿道内利多卡因对接受侵入性尿动力学检查患者的疼痛和尿动力学研究参数的影响。按照系统评价和Meta分析的首选报告项目(PRISMA)方案,在MEDLINE、PubMed和ScienceDirect数据库中对随机对照试验(RCT)进行了系统检索。由两名独立 reviewers 使用Cochrane偏倚风险工具评估研究的偏倚。连续结果的分析以平均差(MD)表示,而比值比用于分析二分数据。使用I2值确定研究之间的异质性。在发现的622篇文章中,共有三项RCT符合分析条件。对这些研究的平均视觉模拟量表差异进行的森林图分析表明,利多卡因组和安慰剂组之间差异不显著(MD -7.68;95% CI -34.04至-18.68,P¼.57)。两组之间所有尿动力学参数结果也相似(P>.05)。在尿动力学研究前常规尿道内注射利多卡因不会影响疼痛强度和尿动力学参数。

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本文引用的文献

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Periurethral Lidocaine Does Not Decrease Pain After Urodynamic Testing in Women: A Double-Blinded Randomized Control Trial.
Female Pelvic Med Reconstr Surg. 2021 May 1;27(5):e528-e532. doi: 10.1097/SPV.0000000000000983.
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Intraurethral Lidocaine Use During Urodynamic Testing Deserves Further Study.
Female Pelvic Med Reconstr Surg. 2020 Jul;26(7):464. doi: 10.1097/SPV.0000000000000789.
5
Reduction of Pain during Flexible Cystoscopy: A Systematic Review and Meta-Analysis.
J Urol. 2019 Dec;202(6):1136-1142. doi: 10.1097/JU.0000000000000399. Epub 2019 Jun 20.
6
Randomized controlled trial of 2% lidocaine gel versus water-based lubricant for multi-channel urodynamics.
Int Urogynecol J. 2018 Sep;29(9):1297-1302. doi: 10.1007/s00192-018-3576-8. Epub 2018 Feb 17.
7
Randomized Controlled Trial to Assess the Impact of Intraurethral Lidocaine on Urodynamic Voiding Parameters.
Female Pelvic Med Reconstr Surg. 2019 Jul/Aug;25(4):265-270. doi: 10.1097/SPV.0000000000000544.
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Modeling the spinal pudendo-vesical reflex for bladder control by pudendal afferent stimulation.
J Comput Neurosci. 2016 Jun;40(3):283-96. doi: 10.1007/s10827-016-0597-5. Epub 2016 Mar 11.
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Dynamics of the sensory response to urethral flow over multiple time scales in rat.
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