title: Intraurethral Lidocaine for Urethral Catheterization in Children: A Randomized Controlled Trial.
abstract: OBJECTIVE
  To determine whether lidocaine is superior to nonanesthetic lubricant (NAL) for relieving pain in children undergoing urethral catheterization (UC).
  
  
  METHODS
  Children 0 to 24 months requiring UC were randomized to NAL or topical and intraurethral 2% lidocaine gel. Primary outcome was facial grimacing in the pre to during drug administration and catheterization phases. Secondary outcome was caregiver satisfaction by using a Visual Analog Scale.
  
  
  RESULTS
  There were 133 participants (n = 68 lidocaine, n = 65 NAL). There were no significant differences in mean (SD) scores during UC between lidocaine and NAL (86.4% [121.5%] vs 85.2% [126.6%]), respectively (Δ [confidence interval (CI)] = -1.2 [-21.0 to 49.0], P = .4). There was a significantly greater difference in mean (SD) scores during instillation of lidocaine versus NAL (61.8% [105.6%] vs 3.2% [84.9%]), respectively (Δ [CI] -58.6 [-95.0 to -32.0], P < .001). There were no significant differences in mean (SD) parental satisfaction scores between lidocaine and NAL (4.8 [3.2] vs 5.9 [2.9]), respectively (CI-0.1 to 2.2; P = .06). In the subgroup analysis, age, gender, and positive urine culture did not significantly influence between-group differences in facial grimacing.
  
  
  CONCLUSIONS
  Compared with NAL, topical and intraurethral lidocaine is not associated with significant pain reduction during UC, but significantly greater pain during instillation. Therefore, clinicians may consider using noninvasive pain-reducing strategies for young children who require UC.
authors.affiliation: Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Children's Health Research Institute, and naveen.poonai@lhsc.on.ca.
authors.forename: Naveen
authors.initials: N
authors.lastname: Poonai
authors.affiliation: Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;
authors.forename: Jennifer
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;
authors.forename: Cindy
authors.initials: C
authors.lastname: Langford
authors.affiliation: Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;
authors.forename: Natasha
authors.initials: N
authors.lastname: Lepore
authors.affiliation: Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada;
authors.forename: Anna
authors.initials: A
authors.lastname: Taddio
authors.affiliation: Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada;
authors.forename: Sandra
authors.initials: S
authors.lastname: Gerges
authors.affiliation: Lawson Health Research Institute, London Health Sciences Centre, London, Ontario, Canada;
authors.forename: Larry
authors.initials: L
authors.lastname: Stitt
authors.affiliation: Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;
authors.forename: John
authors.initials: J
authors.lastname: Teefy
authors.affiliation: Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;
authors.forename: Karim
authors.initials: K
authors.lastname: Manji
authors.affiliation: Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;
authors.forename: Matt
authors.initials: M
authors.lastname: Castelo
authors.affiliation: Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;
authors.forename: Michael
authors.initials: M
authors.lastname: Rieder
authors.affiliation: Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;
authors.forename: Tingting
authors.initials: T
authors.lastname: Qui
authors.affiliation: Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;
authors.forename: Doreen
authors.initials: D
authors.lastname: Matsui
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada; and Women and Children's Health Research Institute, Edmonton, Alberta, Canada.
authors.forename: Samina
authors.initials: S
authors.lastname: Ali
mesh_terms: D000779:Anesthetics, Local / Q000627:therapeutic use*; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008012:Lidocaine / Q000008:administration & dosage* / Q000627:therapeutic use; D054327:Lubricants / Q000008:administration & dosage*; D008297:Male; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D014546:Urinary Catheterization / Q000379:methods*
chemical_list: D000779:Anesthetics, Local; D054327:Lubricants; D008012:Lidocaine