Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

S27: LOWER URINARY TRACT

Moderators: Rafal Chrzan (Netherlands), Pat McKenna (USA)

ESPU Meeting on Saturday 17, October 2015, 15:15 - 16:07

15:15 - 15:20

S27-1

(LO)

★

RANDOMIZED CLINICAL TRIAL OF LIDOCANE ANALGESIA FOR

TRANSURETHRAL BLADDER CATHETERIZATION IN YOUNG CHILDREN

Jonathan ELLISON

, Neil USPAL

, Bonnie STRELIZ

, Kristin FOLLMER

, Taryn COLTON

, Eileen KLEIN

and Paul

MERGUERIAN

1) Seattle Children's Hospital, Pediatric Urology, Seattle, USA - 2) Seattle Children's Hospital, Pediatrics, Seattle, USA -

3) Seattle Children's Hospital, Center for Clinical and Translational Research, Seattle, USA - 4) University of Arizona,

College of Medicine, Tuscon, USA

PURPOSE

Transurethral bladder catheterization (TUBC) is frequently performed for the collection of sterile urine. Intraurethral

lidocaine (IL) reduces pain from TUBC in older children, but efficacy is established in younger patients. We performed a

randomized clinical trial of children in our pediatric emergency department hypothesizing that IL reduces TUBC-

associated pain.

MATERIAL AND METHODS

Children aged 0-36 months undergoing TUBC were randomized to receive 2% IL 5 minutes before procedure or no

analgesia. We filmed baseline infant state, lidocaine application, TUBC, and infant state one minute post-TUBC. Parents

assigned a Visual Analog Scale (VAS) pain score following TUBC. Independent, blinded reviewers assigned pain scores

using Faces, Legs, Arms, Cry, and Consolability (FLACC) and Modified Behavioral Pain Score (MBPS) scales. Pain scores

were compared using the Wilcoxon rank-sum test.

RESULTS

Seventy-three of 80 enrolled patients had analyzable data. Intervention and control groups were similar in mean age

(13 vs 12 mo, respectively) and gender (62% vs 59% female, respectively). No differences were detected in pain by

FLACC or MBPS scores between groups (Table). Results were similar between males and females.

(N = 35)

No Analgesia

(N = 41)

P-Value

FLACC Score post-TURC (median, 95% CI)

8, 7-9

9, 8-10

.09

MBPS score post-TURC (median, 95% CI)

9, 8-9

9, 9-9

0.89

Parental VAS Score, post-TURBC (median, 95% CI) 5, 4-6

7, 6-8

<0.001

FLACC score, IL application (median, 95% CI)

9, 7-9

CONCLUSIONS

Intraurethral lidocaine instillation before TUBC did not improve independently assigned procedural pain scores although

parental perception of pain scores were lower with IL. Further study should be performed to improve analgesia for this

highly painful procedure.