Format

Send to

Choose Destination
Pediatrics. 2015 Oct;136(4):e879-86. doi: 10.1542/peds.2015-1852.

Intraurethral Lidocaine for Urethral Catheterization in Children: A Randomized Controlled Trial.

Author information

1
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.
2
Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada;
3
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada;
4
Lawson Health Research Institute, London Health Sciences Centre, London, Ontario, Canada;
5
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada; and Women and Children's Health Research Institute, Edmonton, Alberta, Canada.

Abstract

OBJECTIVES:

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.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01690767.

PMID:
26416942
DOI:
10.1542/peds.2015-1852
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center