Analgesic effect of intravesical lignocaine in urology surgery: A systematic review and meta-analysis.

IF 2.9 Q1 ANESTHESIOLOGY
Indian Journal of Anaesthesia Pub Date : 2025-02-01 Epub Date: 2025-01-29 DOI:10.4103/ija.ija_950_24
Ka T Ng, Wei E Lim, Wan Y Teoh, Ahmad N B Fadzli, Mohd F B Z Abidin
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引用次数: 0

Abstract

Background and aims: Recent trials showed that transurethral lignocaine for bladder irrigation provides excellent analgesic effects and can minimise catheter-related bladder discomfort. The primary objective was to determine the efficacy of intravesical lignocaine on the incidence of catheter-related bladder discomfort in adult patients undergoing urologic surgery.

Methods: The MEDLINE, EMBASE, and CENTRAL databases were searched from their start date until December 2024. Randomised clinical trials (RCTs) were included, comparing intravesical lignocaine and control for bladder irrigation in adults undergoing urological surgery. The odds ratio (OR) of the incidence of severe, moderate, and mild catheter-related bladder discomfort and the incidence of rescue analgesia were assessed. The revised Cochrane risk-of-bias tool for RCTs was applied to evaluate the risk of bias in all included studies. GRADEpro was used to evaluate the quality of the evidence.

Results: Compared to the control group, our pooled analysis of three RCTs showed that intravesical lignocaine significantly reduced the incidence of severe catheter-related bladder discomfort (OR: 0.27, 95% confidence interval (Cl): 0.12, 0.58, P = 0.0008, grade of evidence: low) and the incidence of moderate catheter-related bladder discomfort (OR: 0.31, 95% Cl: 0.14, 0.67, P = 0.003, grade of evidence: low). It also statistically decreased the incidence of rescue analgesia (OR: 0.06, 95% Cl: 0.02, 0.15, P < 0.00001, grade of evidence: low).

Conclusions: The intravesical administration of lignocaine statistically reduced moderate and severe catheter-related bladder discomfort. There was a significant decrease in the number of patients requiring rescue analgesia in the intravesical lignocaine group.

泌尿外科手术膀胱内注射利多卡因的镇痛效果:系统回顾和荟萃分析。
背景和目的:最近的试验表明经尿道利多卡因膀胱冲洗具有良好的镇痛效果,并可最大限度地减少导管相关的膀胱不适。主要目的是确定膀胱内注射利多卡因对泌尿外科成年患者导尿管相关性膀胱不适发生率的影响。方法:检索MEDLINE、EMBASE和CENTRAL数据库,检索时间为数据库建立日期至2024年12月。纳入随机临床试验(RCTs),比较膀胱内灌注利多卡因和对照组对接受泌尿外科手术的成人膀胱冲洗的影响。评估重度、中度和轻度导管相关性膀胱不适发生率和抢救性镇痛发生率的比值比(OR)。应用修订后的Cochrane随机对照试验风险偏倚工具评估所有纳入研究的偏倚风险。使用GRADEpro来评估证据的质量。结果:与对照组相比,我们对3项随机对照试验的汇总分析显示,膀胱内注射利多卡因显著降低了严重导管相关膀胱不适的发生率(OR: 0.27, 95%可信区间(Cl): 0.12, 0.58, P = 0.0008,证据等级:低)和中度导管相关膀胱不适的发生率(OR: 0.31, 95% Cl: 0.14, 0.67, P = 0.003,证据等级:低)。统计学上也降低了抢救性镇痛的发生率(OR: 0.06, 95% Cl: 0.02, 0.15, P < 0.00001,证据等级低)。结论:膀胱内给药利多卡因可减少中度和重度导尿管相关性膀胱不适。膀胱内注射利多卡因组需要紧急镇痛的患者数量明显减少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.20
自引率
44.80%
发文量
210
审稿时长
36 weeks
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