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CNA509 Assessment 2: Presentation by Keshia Whitehead
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Lignocaine 2% gel for Flexible Cystoscopy
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Procedure:FLEXIBLECYSTOSCOPY
Local please!
Is it better to wait 3 minutes for the Lignocaine to work or can the surgeon proceed with the cystoscope immediately ?
What is going to be more comfortable for me?
3 mins
A randomised prospective clinical trial of 50 male patients undergoing a flexible cystoscopy
Lets find out!Does waiting after insertion of topical anaesthetic lubricant improve patient comfort?
Topical anaesthetic lubricant: Lignocaine 2% gel. (Manufacturer’s recommendation of 3-5 min delay.)
25men receiving 20ml localwithno delay in cystoscopeinsertion.
25 men with initial10ml local then a3 minutewaitfollowed by another 10mls thencystoscope.
How sore were you when the cystoscope was inserted?[100mm visual analogue scale]
Mean pain score difference: 1.24mmno delay=11.94mmwith delay=10.52mm
Post procedure
From this, one could say comfort levels are similar and there’s no need to wait?...
Yes. The trial indicates the pain score is low and flexible cystoscopy is a tolerable procedure so there is no need to delay.
also, food for thought! Those that had to wait might have even felt more anxious from the delay. This could have affected their comfort level too!
Just remember that using topical anaesthetic lubricant reduces pain compared to regular lubricant. So always use some!
Losco, G, Antoniou, S, Mark, S 2011 “Male flexible cystoscopy: does waiting after insertion of topical anaesthetic lubricant improve patient comfort?”, BJU International, vol. 108, no. 2, pp. 42-44, viewed 10 September 2019, PubMed,
<https://www.ncbi.nlm.nih.gov/pubmed/22085126>
CNA509 assessment 2: presentation byKeshia Whitehead
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