Publication: Intraurethral Instillation of Ketamine and Lidocaine versus Lidocaine for Male Rigid Cystoscopy: A Prospective Randomized Controlled Trial
Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Male rigid cystoscopy is one of the most common outpatient procedures in urology
because of it lower cost, better optical area and better orientation compared with
flexible devices. However, performing rigid cystoscopy is not only painful but equally
apprehensive in awake male patients.
Objective
The study was conducted to evaluate the efficacy of lidocaine gel and ketamine
solution together compared with lidocaine gel alone during male rigid cystoscopy.
Method
A total of 76 male patients who visited the hospital for rigid cystoscopy were
randomized into two groups before undergoing cystoscopy. The experimental group
received 15 ml lidocaine with 2 ml (100 mg) Ketamine solution while the control
group received 15 ml lidocaine gel with 2 ml Normal saline. Patient’s heart rate and
mean arterial pressure were recorded in five minutes interval till twenty minutes
after completion of the procedure. The level of pain perception of all the patients
was measured with Visual analogue scale (VAS) score, at the beginning, during and
after cystoscopy. Independent sample t-test was used to compare outcome measures
and p value of < 0.05 was considered statistically significant.
Result
Out of the total 70 patients analyzed at the end of study with 35 patients in each group,
the VAS score in each stage were lower in lidocaine plus ketamine group compared to
lidocaine gel alone. The difference was significant at the commencement and middle
of the procedure (p < 0.05).
Conclusion
Intraurethral instillation of ketamine and lidocaine is more effective in reducing mean
pain score during cystoscopy as compared to lidocaine alone.
KEY WORDS
Cystoscopy, Ketamine, Lidocaine, Visual analogue scale score
Description
Pradhan U,1 Chalise PR,2 Luitel BR,2 Kriti S,3 Devkota S4
1Department of Surgery
Sindhuli Hospital,Sindhuli, Nepal
2Department of Surgery
Tribhuvan University Teaching Hospital, Kathmandu, Nepal
3Department of GP and Emergency Medicine
Nepalese Army Institute of Health Sciences,Kathmandu, Nepal
4Department of Anesthesiology
Sindhuli, Nepal
Keywords
Cystoscopy, Ketamine, Lidocaine, Visual analogue scale score