Related Experiment Video
Updated: Apr 2, 2026
In Vivo Luminal Measurement of Distension-Evoked Urothelial ATP Release in Rodents
Published on: September 7, 2022
Intraurethral Lidocaine for Urethral Catheterization in Children: A Randomized Controlled Trial
Naveen Poonai1, Jennifer Li2, Cindy Langford2
1Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Children's Health Research Institute, and naveen.poonai@lhsc.on.ca.
Insights
Lidocaine gel did not reduce pain during urethral catheterization (UC) in young children compared to nonanesthetic lubricant (NAL). Lidocaine caused more pain during instillation, suggesting noninvasive strategies are preferable for pediatric UC pain relief.
Area of Science:
- Pediatric Pain Management
- Urology
- Anesthesiology
Background:
- Urethral catheterization (UC) in children can be painful.
- Effective pain management during UC is crucial for patient comfort and cooperation.
Purpose of the Study:
- To compare the efficacy of topical and intraurethral lidocaine gel versus nonanesthetic lubricant (NAL) for pain relief during UC in children aged 0-24 months.
Main Methods:
- A randomized controlled trial involving 133 children (0-24 months) undergoing UC.
- Participants were randomized to receive either NAL or 2% lidocaine gel.
- Primary outcome was measured by facial grimacing; secondary outcome was caregiver satisfaction via Visual Analog Scale.
Main Results:
- No significant difference in facial grimacing during UC between the lidocaine and NAL groups (86.4% vs 85.2%).
- Lidocaine group experienced significantly greater facial grimacing during drug instillation compared to NAL (61.8% vs 3.2%).
- Parental satisfaction scores were not significantly different between the two groups.
Conclusions:
- Topical and intraurethral lidocaine does not provide significant pain reduction during UC in young children compared to NAL.
- Lidocaine use is associated with increased pain during the instillation phase.
- Clinicians should consider noninvasive pain-reducing strategies for pediatric UC.
Objectives:
To determine whether lidocaine is superior to nonanesthetic lubricant (NAL) for relieving pain in children undergoing urethral catheterization (UC).
Methods:
Children 0 to 24 months requiring UC were randomized to NAL or topical and intraurethral 2% lidocaine gel. Primary outcome was facial grimacing in the pre to during drug administration and catheterization phases. Secondary outcome was caregiver satisfaction by using a Visual Analog Scale.
Results:
There were 133 participants (n = 68 lidocaine, n = 65 NAL). There were no significant differences in mean (SD) scores during UC between lidocaine and NAL (86.4% [121.5%] vs 85.2% [126.6%]), respectively (Δ [confidence interval (CI)] = -1.2 [-21.0 to 49.0], P = .4). There was a significantly greater difference in mean (SD) scores during instillation of lidocaine versus NAL (61.8% [105.6%] vs 3.2% [84.9%]), respectively (Δ [CI] -58.6 [-95.0 to -32.0], P < .001). There were no significant differences in mean (SD) parental satisfaction scores between lidocaine and NAL (4.8 [3.2] vs 5.9 [2.9]), respectively (CI-0.1 to 2.2; P = .06). In the subgroup analysis, age, gender, and positive urine culture did not significantly influence between-group differences in facial grimacing.
Conclusions:
Compared with NAL, topical and intraurethral lidocaine is not associated with significant pain reduction during UC, but significantly greater pain during instillation. Therefore, clinicians may consider using noninvasive pain-reducing strategies for young children who require UC.
