| Title | A randomized clinical trial of lidocaine gel for reducing infant distress during urethral catheterization. | | Author(s) | Mularoni PP, Cohen LL, DeGuzman M, Mennuti-Washburn J, Greenwald M, Simon HK | | Institution | Children's Healthcare of Atlanta, Atlanta, GA, USA. | | Source | Pediatr Emerg Care 2009 Jul; 25(7):439-43. | | MeSH | Administration, Topical
Anesthetics, Local
Double-Blind Method
Female
Follow-Up Studies
Humans
Infant
Lidocaine
Lubrication
Male
Pain
Pain Measurement
Patient Satisfaction
Retrospective Studies
Treatment Outcome
Urinalysis
Urinary Catheterization
| | Abstract | OBJECTIVES: The purpose of this study was to determine whether a lidocaine-enhanced lubricant that was used topically and instilled into the urethra decreased infants' distress that was associated with catheterization.
METHODS: Eligible study participants were febrile 2- to 24-month-old pediatric emergency department patients in need of a catheter-obtained urinalysis. Patients were randomly assigned to 1 of 3 groups. Patients had catheterization performed after a 4-minute protocol that included a topical lubricant control, topical and intraurethral lubricants, or topical and intraurethral lidocaines. All patients were filmed during the procedure and evaluated at 3 phases: the start of the study, time of instillation, and at the time of maximal catheter insertion. The 3 phases were analyzed by blinded coders using the Modified Behavioral Pain Scale.
RESULTS: A total of 45 patients were enrolled in 1 of the 3 study groups. Patients who received lidocaine had a lower overall distress at a level approaching significance at the time of catheterization (phase 3; P = 0.065) and a significantly lower distress as measured by crying during the catheterization (phase 3; P = 0.036) than infants who did not have a lubricant instilled into the urethra.
CONCLUSIONS: The use of topical and intraurethral lidocaine resulted in a lower distress when compared with a topical lubricant, at a level approaching significance for global distress. When a subsection of the total distress score that measured infant cry was evaluated, the difference between the intraurethral lidocaine group and the group without intraurethral instillation was statistically significant. Although the results are promising, intraurethral lidocaine did not fully alleviate discomfort associated with urethral catherization. The use of lidocaine is suggested for pediatric patients undergoing urethral catherization; however, evaluation of additional agents and techniques for further decreasing pain is also warranted. | | Language | eng | | Pub Type(s) | Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
| | PubMed ID | 19564809 |
|
