Thrasher J B, Kreder K J, Peterson N E, Donatucci C F
Department of Surgery, Duke University Medical Center, Durham, North Carolina.
J Urol. 1993 Aug;150(2 Pt 1):335-6. doi: 10.1016/s0022-5347(17)35477-0.
We describe the use of lidocaine as a topical anesthetic for 35 patients undergoing random bladder biopsies (bladder mappings) and cold-cup resection of small bladder lesions. Serum lidocaine levels were measured 7 to 10 minutes after instillation of the anesthetic using fluorescent polarization immunoassay. Adequate pain control was noted in 33 of 35 patients (94%), with negligible serum lidocaine levels noted in all 35. One patient had a 2 cm. tumor on the anterior wall of the bladder making resection with topical anesthesia suboptimal and 1 patient required 1 mg. supplemental intravenous midazolam hydrochloride to complete the procedure. We conclude that topical lidocaine is a safe, inexpensive and effective mode of anesthesia for bladder mappings and cold-cup biopsies of small bladder lesions. However, it may be inadequate for lesions large enough to require resection rather than cold-cup biopsy and those at poorly accessible regions of the bladder.
我们描述了利多卡因作为局部麻醉剂用于35例接受随机膀胱活检（膀胱图谱绘制）和小膀胱病变冷杯切除术患者的情况。使用荧光偏振免疫分析法在注入麻醉剂7至10分钟后测量血清利多卡因水平。35例患者中有33例（94%）疼痛控制良好，所有35例患者的血清利多卡因水平可忽略不计。1例患者膀胱前壁有一个2 cm的肿瘤，使得局部麻醉下的切除不太理想，1例患者需要补充1 mg静脉注射盐酸咪达唑仑才能完成手术。我们得出结论，局部利多卡因是膀胱图谱绘制和小膀胱病变冷杯活检的一种安全、廉价且有效的麻醉方式。然而，对于大到需要切除而非冷杯活检的病变以及膀胱难以触及区域的病变，它可能并不适用。
