Keywords
Lidocaine gel
Tramadol
Visual Analogue pain Scale score
How to Cite
Abstract
Background: Local anesthesia as lidocaine gel has long been used for cystoscopy using a rigid cystoscope. Recently, tramadol was discovered to also have a local anesthetic effect.
Objectives: We aimed to examine the difference in pain intensity between intraurethral injections of tramadol combined with lidocaine gel and sole lidocaine gel during cystoscopy.
Methods: A prospective comparative study was conducted in Kathmandu Medical College and Teaching Hospital, Kathmandu among 120 males who underwent rigid cystoscopy. All patients were divided into 2 groups, in which group 1 was given a combination of tramadol and lidocaine gel urethral injection 10 minutes before rigid cystoscopy, whereas group 2 was given lidocaine gel urethral injection 10 minutes before rigid cystoscopy. Patient tolerance during the procedure was assessed using visual analogue pain scale score. The scores were recorded three times, first during the entrance of the cystoscope, then during cystoscopy, and finally 15 minutes after removal of the cystoscope.
Results: The visual analogue pain Scale score at the commencement of the procedure, middle of the procedure, and 15 minutes after removal of the cystoscope in lignocaine group was 3.90 ±1.003, 5.75 ± 1.24 and 3.34 ± 1.024 respectively. Similarly, visual analogue pain scale score at the commencement of the procedure, middle of the procedure, and 15 minutes after removal of the cystoscope in lignocaine and tramadol group was 3.43 ±1.079, 5.5 ±1.33 and 2.73± 1.23 respectively. Mean pain scores in all stages were found to be significantly lower in the patients who received lidocaine and tramadol at the entrance of cystoscope, during cystoscopy and 15 min after end of cystoscopy as shown by p-value of 0.03, 0.028 and 0.03 respectively.
Conclusion: The combination of intraurethral tramadol and lidocaine gel can significantly decrease pain during rigid cystoscopy in men more effectively than sole intraurethral lidocaine gel.
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