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Pain Reduction Effects of Lidocaine Gel for Urethral Catheterization : A Systematic Review and Meta-Analysis

요도 카테터 삽입술에서 리도카인 윤활제의 통증 감소 효과 : 체계적 문헌고찰과 메타분석

  • Received : 2017.03.13
  • Accepted : 2017.06.09
  • Published : 2017.06.30

Abstract

This study was a systematic review and meta-analysis that evaluated the results of research on the pain reduction effects of lidocaine gel for urethral catheterization in adults. A literature search was conducted using seven electronic databases, gray literature and other resources based on the guidelines of Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA). A Risk of Bias (RoB) tool was applied to assess the quality of selected studies. Data were analyzed using the RevMan 5.3.-program. Sixteen randomized controlled trials involving 1904 adults were included. RoB was not observed in the funnel plot. Overall, lidocaine gel was effective for pain reduction during urethral catheterization (Standard Mean Difference[SMD] -0.96;95% CI: -1.43, -0.49). To explore the cause of heterogeneity (I2=95%, p<.001), subgroup analysis was conducted according to three catheter types (urinary catheter, flexible cystoscopy, and rigid cystoscopy) and the SMDs were -0.88 (95% CI:-1.51, -0.26), -0.31 (95% CI:-0.63, 0.01), and -1.93 (95% CI:-2.88, -0.97), respectively. A significant pain reduction effect was observed regardless of gender in urinary catheterization. However, in rigid cystoscopy, a significant pain reduction effect was observed only in male subjects. Pain reduction effects were observed when 10~11ml lidocaine gel was used during rigid cystoscopy and when lubrication was used during urinary catheterization, irrespective of application time. These findings suggest that lidocaine gel is a useful anesthetic lubricant for urinary catheterization and rigid cystoscopy in male adults.

Keywords

Lidocaine gel;Meta-analysis;Pain;Systematic review;Urethral catheterization

References

  1. Siderias J, Guadio F, Singer AJ. Comparison of topical anesthetics and lubricants prior to urethral catheterization in males: a randomized controlled trial. Academic Emergency Medicine 2004;11(6):703-706. DOI: https://doi.org/10.1197/j.aem.2003.12.025 https://doi.org/10.1111/j.1553-2712.2004.tb02419.x
  2. M. F. Chan, H. Y. Tan, X. Lian, L. Y. Geraldine , L. L. E. Ang, L. H. L. Lim, W. May, M. C. Yvonne, G. Tan, B. J. Taylor, "A Randomized controlled study to compare the 2% lignocaine and aqueous lubricating gels for female urethral catheterization", Pain Practice, Vol. 14, no. 2, pp. 140-145, 2014. DOI: https://doi.org/10.1111/papr.12016 https://doi.org/10.1111/papr.12056
  3. A. R. Patel, J. S. Jones, D. Babineau, "Lidocaine 2% gel versus plain lubricating gel for pain reduction during flexible cystoscopy:a meta-analysis of prospective, randomized, controlled trials", The Journal of Urology, Vol. 179, no. 3, pp. 986-990, 2008. DOI: https://doi.org/10.1016/j.juro.2007.10.065 https://doi.org/10.1016/j.juro.2007.10.065
  4. D. S. Aaronson, T. J. Walsh, J. F. Smith, B. J. Davis, M. H. Hsieh, B. R. Konety, "Meta-analysis: does lidocaine gel before flexible cystoscopy provide pain relief?", British Journal of Urology International, Vol. 104, no. 4, pp. 506-510, 2009. DOI: https://doi.org/10.1111/j.1464-410x.2009.08417 https://doi.org/10.1111/j.1464-410X.2009.08417.x
  5. M. Steggall, K. Jones, "Anesthetic or lubricating gels for urethral catheterization?", British Journal of Nursing, Vol. 24, no. 9, pp. 12-14, 2015. DOI: https://doi.org/10.12968/bjon.2015.24.sup9.s12
  6. B. R. P. Birch, P. Ratan, R. Morley, J. Cumming, C. J. Smart, J. D. Jenkins, "Flexible cystoscopy in men: is topical anaesthesia with lignocaine gel worthwhile?", British Journal of Urology, Vol. 73, no. 2, pp. 155-159, 1994. DOI: https://doi.org/10.1111/j.1464-410x.1994.tb07484 https://doi.org/10.1111/j.1464-410X.1994.tb07484.x
  7. I. S. Jeong, J. S. Jeong JS, H. J. Seo, E. Y. Lim, Y. H. Hong, K. H. Park, Y. S. Jung, E. K. Choi, H. Y. Park, S. A. Park, "Development of indwelling urinary catheterization guideline by adaptation process", Journal of Korean Clinical Nursing Research, Vol. 21, no. 1, pp.31-43, 2015.
  8. J. Given, "Management of procedural pain in adult patients", Nursing Standard, Vol. 25, no. 14, pp. 34-40, 2010. DOI: https://doi.org/10.7748/ns2010.12.25.14.35.c8153
  9. G. Yerlikaya, T. Laml, K. Elenskaia, E. Hanzal, H. Kolbl, W. Umek, "Pain perception during outpatient cystoscopy: a prospective controlled study", European Journal of Obstetrics & Gynecology and Reproductive Biology, Vol. 173, pp. 101-105, 2014. DOI: https://doi.org/10.1016/j.ejogrb.2013.11.007 https://doi.org/10.1016/j.ejogrb.2013.11.007
  10. National Clinical Guideline Centre (UK). Infection: Prevention and Control of Healthcare-Associated Infections in Primary and Community Care: Partial Update of NICE Clinical Guideline 2. London: Royal College of Physicians (UK), 2012 Mar. (NICE Clinical Guidelines, No. 139.) Available From: https://www.ncbi.nlm.nih.gov/books/NBK115271/[cited 2017 Jan 20]
  11. W. Doherty, "Instillagel: an anaesthetic antiseptic gel for use in catheterization", British Journal of Nursing, Vol. 8, no. 2, pp.109-112, 1999. DOI: http://dx.doi.org/ 10.12968/bjon.1999.8.2.670 https://doi.org/10.12968/bjon.1999.8.2.6709
  12. Y. T. Chen, P. J. Hsiao, W. Y. Wong, C. C. Wang , S. S. D. Yang, C. H. Hsieh, "Randomized double- blind comparison of lidocaine gel and plain lubricating gel in relieving pain during flexible cystoscopy", The Journal of Urology, Vol. 19, no. 2, pp.163-166, 2005. DOI: https://doi.org/10.1016/s0022-5347(05)00856-6
  13. P. Tanabe, R. Steinman, J. Anderson, D. Johnson, S. Metcalf, E. Ring-Hurn, "Factors affecting pain scores during female urethral catheterization", Academic Emergency Medicine, Vol. 11, no. 6, pp.699-702, 2004. DOI: https://doi.org/10.1197/j.aem.2003.10.029 https://doi.org/10.1111/j.1553-2712.2004.tb02418.x
  14. M. Borch, E. Scosyrev, B. Baron, J. Encarnacion, E. M. Smith, E. Messing, "A Randomized trial of 2% lidocaine gel versus plain lubricating gel for minimizing pain in men undergoing flexible cystoscopy", Urologic Nursing, Vol. 33, no. 4, pp.187-193, 2013. DOI: https:// doi.org/10.7257/1053-816X.2013.33.4.187
  15. C. Chung, M. Chu, R. Paoloni, M. J. O'Brien, T. Demel, "Comparison of lignocaine and water-based lubricating gels for female urethral catheterization: a randomized controlled trial", Emergency Medicine Australasia, Vol. 19, no. 4, pp.315-319, 2007. DOI: https://doi.org/10.1111/j.1742-6723.2007.00961.x https://doi.org/10.1111/j.1742-6723.2007.00961.x
  16. S. Y. Seoung, Y. W. Kim, M. R. Kim, Y. S. Yoon, "Usefulness of local anesthesia for urethral catheterization", Journal of the Korean Society of Emergency Medicine, Vol. 21, no. 6, pp.867-871, 2010.
  17. O. H. Harmanli, O. Okafor, R. Ayaz, A. Knee, "Lidocaine Jelly and plain aqueous gel for urethral straight catheterization and the q-tip test: a randomized controlled trial", Obstetrics & Gynecology, Vol. 114, no. 3, pp.547-55, 2009. DOI: https://doi.org/10.1097/aog0b013e3181b43808 https://doi.org/10.1097/AOG.0b013e3181b43808
  18. PRISMA TRANSPARENT REPORTING of SYSTEMATIC REVIEWS and META-ANALYSES. [Internet]. Preferred reporting items for a systematic review and meta-analysis of individual participant data: the PRISMA-IPD statement. From: http://www.prismastatement.org/Translations/Translations.aspx(accessed Oct., 10, 2016)
  19. J. P. Higgins, S. Green., "Cochrane handbook for systematic reviews of interventions", p. 244, The Cochrane Collaboration, 2011.
  20. S. Y. Kim, J. E. Park, H. J. Seo, Y. J. Lee, B. H. Jang, H. J. Son, H. S. Suh, C. M. Shin, NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. Seoul, ROK: National Evidence-based Healthcare Collaborating Agency, 2011[cited 2016 Dec 2]. Available From: http://www. neca.re.kr/center/paper/report_view.jsp?boardNo=GA&seq=17&q=626f6172644e6f3d4741.
  21. S. P. Hozo, B. Djulbegovic, I. Hozo, "Estimating the mean and variance from the median, range, and the size of a sample", BioMed Central Medical Research Methodology, Vol. 5, no. 13, pp. 1-10, 2005. DOI: https://doi.org/10.1186/1471-2288-5-13 https://doi.org/10.1186/1471-2288-5-1
  22. G. W. Cundiff, A. E. Bent, "Endoscopic evaluation of the lower urinary tract", Urogynecology and Reconstructive Pelvic Surgery. 3rd ed, p.114. Philadelphia : Mosby Elsevier, 2007.
  23. K. S. Jang, K. H. Chung, J. Y. Choi, J. J. Yang, S. J. Park, S. A. Ryu, N. Y. Kim, J. Y. Sim, "Nursing activities and outcomes related to indwelling urinary catheterization from a review of medical records and interviews", Journal of the Korean Society of Nursing Science, Vol. 15, no. 4, pp. 438-448, 2008.
  24. S. Seklehner, M. Remzi, H. Fajkovic, Z. Saratlija-Novakovic, M. Skopek, I. Resch, M. Skopek, I. Resch, M. Duvnjak, S. Hruby, D. Librenjak, W. Hubner, E. Breini, C. Riedl, P. F. Engelhardt, "Prospective multi-institutional study analyzing pain perception of flexible and rigid cystoscopy in men", Urology, Vol. 85, no. 4, pp. 737-741, 2015. DOI: http://dx.doi.org/10.1016/j.urology.2015.01.007 https://doi.org/10.1016/j.urology.2015.01.007
  25. W. Krajewski, R. Zdrojowy, J. Wojciechowska, K. Koscielska, J. Dembowski, M. Matuszewski, K. Tupikowski, B. Malkiewicz, A. Kolodzie, "Patient comfort during flexible and rigid cystourethroscopy", Videosurgery and Other Miniinvasive Techniques. Vol. 11, no. 2, pp. 94-97, 2016. Epub 2016 Jun 17. DOI: http://dx.doi.org/10.5114/wiitm.2016.60665
  26. A. Akkoc, M. Kartalmis, C. Aydin, R. Topaktas, S. Altin, A. Aykac, "2% Lidocaine gel or plain lubricating gel: Which one should be used in male flexible cystoscopy?", Turkish Journal of Urology. Vol. 42, no. 2, pp. 92-96, 2016. DOI: https://doi.org/10.5152/tud.2016.18784 https://doi.org/10.5152/tud.2016.18784
  27. M. C. Cano-Garcia, R. Casarez-Perez, M. Arrabal-Martin, S. Merino-Salas, M. A. Arrabal-Polo, "Use of lidocaine 2% gel does not reduce pain during flexible cystoscopy and is not cost-effective", Urology Journal, Vol. 12, no. 5, pp. 2362-2365, 2015.
  28. K. Stav, R. Ohlgisser, Y. I. Siegel, I. Beberashvili , A. Padoa, A. Zisman, "Pain during female urethral catheterization: intraurethral lubricant injection versus catheter tip lubrication-A prospective randomized trial", The Journal of urology, Vol. 194, no. 4, pp. 1018-1021, 2015. https://doi.org/10.1016/j.juro.2015.03.097
  29. K. J. Ho, T. J. Thompson, A. O'Brien, M. R. Young, G. McCleane, "Lignocaine gel: does it cause urethral pain rather than prevent it?", European urology, Vol. 43, no. 2, pp. 194-196, 2003. https://doi.org/10.1016/S0302-2838(02)00549-3
  30. G. f. Rousseau, M. Oram, J. Barrington, M. Priston , M. Swart, "Plasma lidocaine concentrations following insertion of 2% lidocaine gel into the uterine cavity after uterine balloon thermal ablation", British Journal of Anaesthesia, Vol. 89, no. 6, pp. 846-848, 2002. DOI: https://doi.org/10.1093/bja/aef267 https://doi.org/10.1093/bja/aef267