Use of iontophoretic anaesthesia in urologic surgery: a preliminary experience

Iontophoretic anaesthesia involves the active transport of lignocaine into underlying tissues, by means of an electric field, for anaesthesia. Its use in urology in transurethral operations on the bladder and prostate have been well documented. We present a preliminary experience of its use in the following cases: a transurethral resection of a bladder tumour, a transurethral resection of bladder cysts and incision of the bladder neck and a transurethral resection of the prostate. In the few cases that we did, we found that patient selection and patient preparation is of utmost importance as unlike a complete anaesthesia, the patients can feel deep pressure and heat if diathermy is prolonged. It is also important not to oversedate the patients with midazolam as an uncooperative patient may render any procedure impossible. The greatest drawback of this procedure is that the degree of anaesthesia tends to vary from person to person. As such, it is difficult to predict who would or would not respond to this from of anaesthesia. However, with improvements in protocols, current delivery systems and different anaesthetic agents used, one may see a proliferation of this form of anaesthesia in urology in the not too distant future.