title: Lidocaine as topical anesthesia for bladder mappings and cold-cup biopsies.
abstract: 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.
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: J B
authors.initials: JB
authors.lastname: Thrasher
authors.forename: K J
authors.initials: KJ
authors.lastname: Kreder
authors.forename: N E
authors.initials: NE
authors.lastname: Peterson
authors.forename: C F
authors.initials: CF
authors.lastname: Donatucci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods; D001706:Biopsy; D005260:Female; D006801:Humans; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D001743:Urinary Bladder / Q000473:pathology* / Q000601:surgery*
chemical_list: D008012:Lidocaine