Amano T, Ohkawa M, Kunimi K, Oshinoya Y, Uchibayashi T
Department of Urology, Kanazawa University School of Medicine, Japan.
Int Urol Nephrol. 1995;27(5):533-7. doi: 10.1007/BF02564737.
A total of 62 patients were randomized to receive bladder biopsy and cautery with either topical lidocaine anaesthesia or caudal anaesthesia. The patients were asked to describe the level of pain experienced during the procedure on a scale from 0 (no pain) to 5 (unbearable pain). In 29 patients receiving topical lidocaine anaesthesia, the mean value was 1.6 at cold-cup biopsies and 2.7 at cautery, which were considered to be tolerable for the patients. On the other hand, in 33 patients who had biopsies and cautery with caudal anaesthesia, the mean values were 0.8 and 1.0, respectively, which were significantly lower than those in patients receiving topical anaesthesia (p < 0.01). Serum lidocaine levels were measured in 5 patients at 15 minutes from the beginning of biopsies, and were negligible. These results revealed that caudal anaesthesia provided more effective pain relief, although most patients could tolerate biopsy and cautery with topical lidocaine anaesthesia. The technique of topical anaesthesia is very simple and no side effects were observed. We thus conclude that topical lidocaine anaesthesia is useful and safe for bladder biopsies and cautery in most cases.
共有62例患者被随机分为两组，分别接受局部利多卡因麻醉或骶管麻醉下的膀胱活检及烧灼术。要求患者根据0（无疼痛）至5（无法忍受的疼痛）的量表描述手术过程中所经历的疼痛程度。在29例接受局部利多卡因麻醉的患者中，冷杯活检时的平均值为1.6，烧灼术时为2.7，患者认为这些疼痛程度是可以耐受的。另一方面，在33例接受骶管麻醉下活检及烧灼术的患者中，平均值分别为0.8和1.0，显著低于接受局部麻醉的患者（p<0.01）。在活检开始后15分钟对5例患者测量血清利多卡因水平，结果可忽略不计。这些结果表明，尽管大多数患者能够耐受局部利多卡因麻醉下的活检及烧灼术，但骶管麻醉能提供更有效的疼痛缓解。局部麻醉技术非常简单，且未观察到副作用。因此，我们得出结论，在大多数情况下，局部利多卡因麻醉对于膀胱活检及烧灼术是有用且安全的。
