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Randomized Controlled Trial
. 2024 Dec 19;24(1):457.
doi: 10.1186/s12871-024-02848-4.

Effect of continuous infusion in alleviating pain during male urethral catheterization

Lijun Cao #  1   2 , Xin Qi #  3 , Dan Liu  1   4 , Xincheng Mao  5 , Liu Luo  5 , Mengjiang Liu  6 , Xinyi Wen  7 , Chunhong Cui  8 , Jia Qi  1   2 , Junmei Xu  1 , Yulong Cui  9   10   11
Affiliations
Randomized Controlled Trial

Effect of continuous infusion in alleviating pain during male urethral catheterization

Lijun Cao et al. BMC Anesthesiol. .

Abstract

Aims: The aim of this study was to explore whether continuous infusion causing lubrication can effectively alleviate pain during male urethral catheterization.

Methods: This prospective, multicenter, double-blinded study included 190 male patients scheduled for urethral catheterization. Patients were randomly allocated into four groups: Group A: the catheter was lubricated with paraffin; Group B: the catheter was lubricated with compound lidocaine gel; Group C: the pump continuously infusing with sterilized water; Group D: the pump continuously infusing with 2% lidocaine. The primary outcome was the visual analogue scale (VAS) scores. Statistical analysis system (SAS) (version 9.4) was used to perform all the statistical analyses. Significance for all results was set at P < 0.05.

Results: The VAS of Group D was the lowest (18.90 ± 11.44), followed by the Group C (33.00 ± 11.07), and the VAS of Group A was the highest (53.98 ± 14.76). There were significant differences in VAS in Group D compared to Group A(P < 0.0001), Group B(P < 0.0001) and Group C (P < 0.0001), Group C compared to Group A (P < 0.0001) and Group B(P < 0.0001), Group B compared to Group A (P < 0.0001), indicating that patients treated with lidocaine infusion (Group D) experienced significantly less pain than did those in the other three groups.

Conclusions: Continuous infusion with sterilized water during catheterization is an efficient method for lubricating the urethral mucosa; furthermore, infusion with 2% lidocaine provides better analgesia as well as lubrication.

Trial registration: The study protocol was registered in the Chinese Clinical Trial Registry (ChiCTR2300070866) ( https://www.chictr.org.cn/showproj.html?proj=194591 ) on Apr. 25th, 2023.

Keywords: Continuous infusion; Multicenter study; Pain; Urethral catheterization.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the Clinical Research Ethics Committee of the Second Xiangya Hospital, Central South University. The trial was strictly designed in accordance with the CONSORT statement and Helsinki Declaration, and all the patients have signed the informed consent to participate the study before the procedure. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study flow diagram. A total of 215 male patients were selected for screening, 200 were assessed for eligibility, and each group was randomly assigned 50 patients. 10 patients (2 in Group A, 6 in Group C, and 2 in Group D) were excluded because of mistaken inclusion or their own request to withdraw from the study. Hence, 48 patients in Group A, 50 patients in Group B, 44 patients in Group C, and 48 patients in Group D were included in the analysis. Changes in BP and HR were recorded during catheterization. Group A: The catheter was lubricated with paraffin; Group B: The catheter was lubricated with compound lidocaine gel; Group C: The pump continuously infusing with sterilized water without the catheter lubricated; Group D: The pump continuously infusing with 2% lidocaine without the catheter lubricated
Fig. 2
Fig. 2
VAS of the four groups during catheterization. The VAS of Group D was the lowest (18.90 ± 11.44), followed by Group C (33.00 ± 11.07), and the VAS of Group A was the highest (53.98 ± 14.76). And there were significantly differences in Group D compared to Group A (P < 0.0001), Group B (P < 0.0001), and Group C (P < 0.0001) separately, indicating that patients treated with lidocaine infusion (Group D) experienced significantly less pain than did the other three groups. Group A: The catheter was lubricated with paraffin; Group B: The catheter was lubricated with compound lidocaine gel; Group C: The pump continuously infusing with sterilized water through the front end of the catheter; Group D: The pump continuously infusing with 2% lidocaine
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