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http://dx.doi.org/10.5762/KAIS.2017.18.6.438

Pain Reduction Effects of Lidocaine Gel for Urethral Catheterization : A Systematic Review and Meta-Analysis  

Hong, Hyun-Jung (Department of Nursing, Yeungjin College)
Kim, Ga-Eun (College of Nursing, Keimyung University)
Lee, Ha-Nee (Keimyung University Dongsan Medical Center)
Lee, A-Reum (Gyeongsan City Health Center)
Publication Information
Journal of the Korea Academia-Industrial cooperation Society / v.18, no.6, 2017 , pp. 438-448 More about this Journal
Abstract
This study was a systematic review and meta-analysis that evaluated the results of research on the pain reduction effects of lidocaine gel for urethral catheterization in adults. A literature search was conducted using seven electronic databases, gray literature and other resources based on the guidelines of Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA). A Risk of Bias (RoB) tool was applied to assess the quality of selected studies. Data were analyzed using the RevMan 5.3.-program. Sixteen randomized controlled trials involving 1904 adults were included. RoB was not observed in the funnel plot. Overall, lidocaine gel was effective for pain reduction during urethral catheterization (Standard Mean Difference[SMD] -0.96;95% CI: -1.43, -0.49). To explore the cause of heterogeneity (I2=95%, p<.001), subgroup analysis was conducted according to three catheter types (urinary catheter, flexible cystoscopy, and rigid cystoscopy) and the SMDs were -0.88 (95% CI:-1.51, -0.26), -0.31 (95% CI:-0.63, 0.01), and -1.93 (95% CI:-2.88, -0.97), respectively. A significant pain reduction effect was observed regardless of gender in urinary catheterization. However, in rigid cystoscopy, a significant pain reduction effect was observed only in male subjects. Pain reduction effects were observed when 10~11ml lidocaine gel was used during rigid cystoscopy and when lubrication was used during urinary catheterization, irrespective of application time. These findings suggest that lidocaine gel is a useful anesthetic lubricant for urinary catheterization and rigid cystoscopy in male adults.
Keywords
Lidocaine gel; Meta-analysis; Pain; Systematic review; Urethral catheterization;
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