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CNA509 Assessment 2: Presentation by Keshia Whitehead

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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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