ESPU Congress 2017 - Abstract book

209

19–22 APRIL, 2017, BARCELONA, SPAIN

17:20–17:23

S19-8 (PP)

LIDOCAINE GEL FOR URETHRAL CATHETERIZATION

IN CHILDREN: A META-ANALYSIS

Paul Nimrod FIRAZA

, Michael CHUA

, Jessica MING

, Jan Michael SILANGCRUZ

and Armando LORENZO

1) Jose R. Reyes Memorial Medical Center, Department of Urology, Manila, PHILIPPINES - 2) The Hospital for

Sick Children, Division of Urology, Toronto, CANADA - 3) Hospital for Sick Children, Urology, Toronto, CANADA -

4) St. Luke’s Medical Center, Institute of Urology, Quezon City, PHILIPPINES

PURPOSE

Lidocaine gel can be used as a lubricating agent to reduce any pain or discomfort during urethral

catheterization in children; however, studies have shown conflicting results. Herein, we aim to

determine the efficacy and safety of lidocaine gel versus controls in this population.

MATERIAL AND METHODS

Systematic literature search was done up to September 2016 (PROSPERO CRD42016050018).

Risks of bias were assessed according to the Cochrane collaboration recommendations. The

pain scale assessment scores used in the studies were extracted as mean differences (MD) and

standard deviations for each treatment group. For between group estimation, standardized mean

difference (SMD) was extrapolated with 95% confidence interval (CI). Effect estimates were pooled

using the inverse variance method with appropriate meta-regression model according to inter-study

heterogeneity. Inter-study heterogeneity was assessed using Chi

and I

. Subgroup analyses were

performed for different age ranges.

RESULTS

Five studies (369 subjects) were eligible for the meta-analysis. Overall, pooled effect estimates

show that lidocaine gel has no significant difference in decreasing catheterization associated pain in

children when compared to controls (SMD-0.22, 95%CI-0.66 to 0.21). Effect estimates from 4 stud-

ies that studied children less than 4 year old, revealed no difference in pain reduction between the

lidocaine gel and control groups (SMD 0.01, 95%CI 0-0.22 to 0.24). One study assessed children

ages 4 years or older and showed a significant improvement on pain control in favour of lidocaine

gel group (SMD-1.84, 95%CI-0.69 to 0.20). No serious adverse events from the lidocaine were

reported in any of the studies.

CONCLUSIONS

Current evidence showed that lidocaine gel does not reduce urethral catheterization pain in children,

particularly among the age group.