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Lidocaine Gel for Urethral Catheterization in Children: A Meta-Analysis

Michael E Chua1, Paul Nimrod B Firaza2, Jessica M Ming3

  • 1The Hospital for Sick Children Toronto, Toronto, Ontario, Canada; St. Luke's Medical Center, Quezon City, Philippines.

The Journal of Pediatrics
|September 18, 2017
PubMed

Insights

Lidocaine gel offers no significant pain reduction for pediatric transurethral bladder catheterization compared to nonanesthetic gel. This finding is particularly true for children under four years old.

Area of Science:

  • Pediatric Anesthesiology
  • Urology
  • Pain Management

Background:

  • Transurethral bladder catheterization (TUBC) is a common procedure in pediatric care.
  • Procedural pain during TUBC can cause distress and anxiety in children.
  • Effective pain management strategies are crucial for improving patient experience.

Purpose of the Study:

  • To systematically evaluate the efficacy and safety of lidocaine gel versus nonanesthetic gel (NAG) for pain reduction during pediatric TUBC.
  • To determine if lidocaine gel provides a significant benefit over NAG in alleviating procedural pain.

Main Methods:

  • A systematic literature search was conducted across electronic databases and trial registries up to September 2016.
  • Included were randomized controlled trials (RCTs) comparing lidocaine gel and NAG for TUBC pain in children.
  • Data were pooled using a random-effects model, with subgroup analysis for age groups.

Main Results:

  • Five RCTs involving 369 children were analyzed.
  • Lidocaine gel showed no statistically significant benefit in reducing TUBC pain compared to NAG (SMD, -0.22; 95% CI, -0.65 to 0.21).
  • No difference in pain reduction was observed in children younger than 4 years (SMD, 0.01; 95% CI, -0.22 to 0.24), and no serious adverse events were reported.

Conclusions:

  • Lidocaine gel does not appear to be more effective than NAG in reducing pain associated with pediatric TUBC.
  • The findings suggest that lidocaine gel may not offer a significant advantage for pain management in this procedure, especially in younger children.
Abstract

Keywords:
painsafetytreatment efficacy

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