NaHCO3-Buffered Lidocaine Gel for Outpatient Rigid Cystoscopy in Men

Abstract

Purpose: The purpose of this study was to explore the effect of NaHCO3-buffered lidocaine gel as a topical anesthetic agent for pain relief for rigid cystoscopy.

Design: Prospective randomized controlled trial.

Methods: ASA I-II male patients undergoing rigid cystoscopy randomly received 10 mL 2% Carbocaine lidocaine gel with 1 mL 0.9% saline (group 1) or 1 mL 5% NaHCO3 solution (group 2). After 3 minutes exposure, the cystoscope was inserted into the urethra. On receiving the gel, cystoscope insertion, and intravesical observation, pain score was recorded using the visual analog scale.

Findings: The gel pH with or without NaHCO3 was 7.20 and 6.41, respectively. The concentration of soluble lidocaine in the gel was stable for 24 hours or more. The visual analog scale score in group 2 was significantly lower (1.3 ± 0.9) than in group 1 (5.28 ± 1.99). No adverse effects were recorded.

Conclusion: Alkalized lidocaine gel resulted in successful analgesia for rigid cystoscopy in men without adverse effects.

Keywords: alkalization; cystoscopy; lidocaine gel; topical anesthesia.