A Clinical Evaluation of Urethral Topical Anesthetics for Urological Procedures

Choi, Kyung Jin; Lee, Hee Yong

Abstract

In order to find a more satisfactory pain relieving agent for endoscopic examinations and other urological procedures, various urethral topical anesthetics and analgesics were evaluated clinically on a total of 147 male patients. Mean age of three patients was 46 years old with range of 16~78. The procedures performed in this study were: Cystoscopy in 50; cystoscopy and panendoscopy. 77: panendoscopy only 1; cystoscopy and ureteral catheterization, 15; cystoscopy and lithorapaxy, 1 and urethral dilatation, 3. The anesthetics and analgesics used in this study were as follow: Group 1 consisted of 7 patients with intramuscular injection of 50mg of demerol 30 minutes before the procedure and urethral lubrication with surgical jelly, Group II. 10 patients, urethral instillation of 2% procaine solution for 10 minutes and urethral lubrication with surgical jelly. Group III. 13 patients, urethral instillation of 2% lidocaine solution for 10 minutes and urethral lubrication with surgical jelly. Group IV. 112 patients, urethral instillation of 2% lidocaine jelly only for 10 minutes and Group V, 5 patients, urethral instillation of 2% lidocaine jelly with intravenous injection of 50mg of demerol 10 minutes before the procedure. Degree of pain after exposure of the anesthetics was recorded as the following 5 different categories: +++: severe pain, intolerability of the procedures ++ : moderate pain tolerance of the procedures + : mild pain, tolerance of the procedures +/- : slight pain with discomfort - : no pain with only discomfort Tentative criteria of judging effectiveness of anesthetics were as follows: + ~ +++ : unsatisfactory results - ~ +/- : satisfactory results The effectiveness of the anesthetics used for various urological endoscopic procedure was summarized as follows : The satisfactory results were obtained in 20% group II, in 23% group III, it 65% of group IV, and in 80% of group V.