title: Cooled lignocaine gel: does it reduce urethral discomfort during instillation?
abstract: BACKGROUND
  Topical urethral analgesia with 2% lignocaine gel for office procedures is an accepted practice in contemporary urology. However, instillation of 2% lignocaine gel into the urethra is associated with discomfort in some patients.
  
  
  METHODS
  Forty consenting men reporting for cystoscopy under local anesthesia were randomized to receive 10 ml of 2% lignocaine hydrochloride gel at 4 degrees C and 22 degrees C. After instillation of the gel the patients were immediately asked to score the pain using a nongraphical visual analogue scale.
  
  
  RESULTS
  The pain scores were analyzed using the paired Student's t-test. There was significant reduction in pain scores in the group receiving gel at 4 degrees C compared with the group at 22 degrees C (P < 0.05).
  
  
  CONCLUSIONS
  Refrigerating the gel to 4 degrees C can significantly reduce the initial discomfort associated with instillation of 2% lignocaine hydrochloride into the male urethra.
authors.affiliation: Department of Urology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Goel
authors.forename: Monish
authors.initials: M
authors.lastname: Aron
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000698:Analgesia / Q000379:methods; D000779:Anesthetics, Local / Q000627:therapeutic use; D003080:Cold Temperature; D003558:Cystoscopy / Q000009:adverse effects / Q000379:methods*; D005782:Gels; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D017060:Patient Satisfaction; D011336:Probability; D012016:Reference Values; D016896:Treatment Outcome; D014521:Urethra / Q000187:drug effects*
chemical_list: D000779:Anesthetics, Local; D005782:Gels; D008012:Lidocaine