title: Randomized trial of 10 mL and 20 mL of 2% intraurethral lidocaine gel and placebo in men undergoing flexible cystoscopy.
abstract: OBJECTIVE
  To determine if 20 mL of 2% intraurethral lidocaine gel is superior to 10 mL of 2% lidocaine or sterile lubricant for flexible cystoscopy in men.
  
  
  METHODS
  A randomized, double-blind, placebo-controlled trial was conducted. Sixty men scheduled to undergo diagnostic flexible cystoscopy were randomized to receive either 20 mL of placebo gel (Group I), 10 mL, of 2% lidocaine gel (Group II) or 20 mL of 2% lidocaine gel (Group III). A penile clamp was applied for 15 minutes to ensure consistent indwelling time in all patients. Patients recorded their pain on a 10-cm non-graphical visual analog scale prior to cystoscopy as a baseline, during the procedure, and immediately after the procedure. Patients also recorded their pain and willingness to have the same anesthetic on a 4-point descriptive scale. Heart rate and mean arterial blood pressure (MAP) were recorded at specific intervals throughout the procedure, and increases in mean arterial pressure were considered objective evidence of patient pain.
  
  
  RESULTS
  Pain perception was not statistically different in the groups (Group I 4.65, Group II 3.93, Group III 3.57; P = 0.406). Pain assessment and willingness to have the same anesthetic also did not differ statistically among the groups. Similarly, differences in the increases in MAP were not statistically significant between groups.
  
  
  CONCLUSIONS
  Instillation of 20 mL or 10 mL of 2% lidocaine gel has no advantage over plain lubricant in providing anesthesia for flexible cystoscopy in men.
authors.affiliation: Division of Urology, St. Joseph's Health Care London, University of Western Ontario, Canada.
authors.forename: N
authors.initials: N
authors.lastname: McFarlane
authors.forename: J
authors.initials: J
authors.lastname: Denstedt
authors.forename: S
authors.initials: S
authors.lastname: Ganapathy
authors.forename: H
authors.initials: H
authors.lastname: Razvi
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003558:Cystoscopy / Q000379:methods*; D004311:Double-Blind Method; D005782:Gels; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008153:Lubrication; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D014521:Urethra
chemical_list: D000779:Anesthetics, Local; D005782:Gels; D008012:Lidocaine