Choong S, Whitfield H N, Meganathan V, Nathan M S, Razack A, Gleeson M
Department of Urology, Central Middlesex Hospital NHS Trust, London, UK.
Br J Urol. 1997 Jul;80(1):69-71. doi: 10.1046/j.1464-410x.1997.00214.x.
To determine the optimum duration for the retention of 2% lignocaine gel intraurethrally as an anaesthetic for flexible cystoscopy in men.
A prospective, randomized, double-blind, placebo-controlled trial was conducted in two parts. Initially, the importance of duration was determined, i.e. whether pain relief was significantly improved when lignocaine gel was instilled for longer than is currently practised. As pain relief was improved by retaining the lignocaine gel for longer, the optimum time was determined in a second trial. Initially, 90 patients were divided into four groups receiving 20 mL of 2% lignocaine gel or plain lubricating gel for 5 or 25 min. Subsequently, 60 men were divided into two groups receiving 20 ml of 2% lignocaine gel for 15 or 25 min. The patients' discomfort was recorded using a 4-point descriptive pain scale and a 100 mm non-graphical visual analogue scale.
In the first study, those patients receiving lignocaine gel for 25 min experienced significantly less pain than the other three groups. In the second, lignocaine gel in the urethra for 15 min provided the same level of pain relief as lignocaine for 25 min.
Pain during flexible cystoscopy can be significantly reduced when 20 mL of 2% lignocaine gel is left in the urethra for 15 min; lignocaine gel would be more effective when left for longer than is currently practised.
确定男性行软性膀胱镜检查时尿道内留置2%利多卡因凝胶作为麻醉剂的最佳时长。
前瞻性、随机、双盲、安慰剂对照试验分两部分进行。首先，确定时长的重要性，即当利多卡因凝胶的注入时长超过目前的做法时，疼痛缓解是否有显著改善。由于延长利多卡因凝胶的留置时间可改善疼痛缓解情况，因此在第二项试验中确定了最佳时间。最初，90名患者被分为四组，分别接受20毫升2%利多卡因凝胶或普通润滑凝胶，留置5分钟或25分钟。随后，60名男性被分为两组，分别接受20毫升2%利多卡因凝胶，留置15分钟或25分钟。使用4级描述性疼痛量表和100毫米非图形视觉模拟量表记录患者的不适情况。
在第一项研究中，接受25分钟利多卡因凝胶的患者疼痛明显少于其他三组。在第二项研究中，尿道内留置15分钟的利多卡因凝胶与留置25分钟的利多卡因凝胶的疼痛缓解水平相同。
当20毫升2%利多卡因凝胶在尿道内留置15分钟时，软性膀胱镜检查期间的疼痛可显著减轻；利多卡因凝胶留置时间长于目前的做法时效果更佳。
