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Efficiency of intracavitary Levobupivacaine infusion for pain management during cystoscopic procedures: A randomized study
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  • Mehmet Pehlivaoğlu,
  • Hasan Huseyin Tavukcu,
  • Oktay Akça,
  • Serkan Yenigürbüz,
  • Yusuf İlker Çömez,
  • Ömer Onur Çakır
Mehmet Pehlivaoğlu
University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital
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Hasan Huseyin Tavukcu
University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital
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Oktay Akça
Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
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Serkan Yenigürbüz
University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital
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Yusuf İlker Çömez
Memorial Bahçelievler Hospital, Istanbul, Turkey
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Ömer Onur Çakır
King’s College Hospital NHS Foundation Trust, London, United Kingdom
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Abstract

Aim: This study evaluated the effect of intracavitary levobupivacaine infusion diluted with locally applied isotonic solution for pain control in cystoscopy. Methods: Included in this study are 100 patients who had previously undergone transurethral tumor resection for bladder tumor and were followed up by cystoscopy. The patients were randomized into five groups (n = 20). In the first, second, third, and fourth groups, 4, 6, 8, and 10 mL of levobupivacaine HCl (5.0 mg/mL) were mixed with 26, 24, 22, and 20 mL of isotonic solution, respectively. Hence, the total mixture was 30 mL for each group. The fifth group was the control group. In this group, the standard method commonly used in most clinics was utilized. That is, a gel containing Cathejell-2% lidocaine (25 mg lidocaine) was applied. Cystoscopic interventions were performed with a 17.5 Fr rigid cystoscope and 0°, 30°, and 70° lens. During cystoscopy and 30 min later, the pain status of patients was assessed using the Visual Analogue Scale (VAS), and patient satisfaction was questioned. Results: The mean VAS score during and after the cystoscopy procedure was significantly lower in the levobupivacaine groups compared to the lidocaine group. In addition, patient satisfaction in the levobupivacaine groups was significantly higher than in the lidocaine group. No drug-related side-effects were observed in all groups. Conclusion: Thus, levobupivacaine is a more effective drug than lidocaine alone to control pain during cystoscopy. The use of levobupivacaine is recommended to prevent possible complications of general anesthesia by eliminating the need for the aforementioned as well as its cost-saving advantage.

Peer review status:Published

18 Nov 2020Submitted to International Journal of Clinical Practice
19 Nov 2020Submission Checks Completed
19 Nov 2020Assigned to Editor
03 Dec 2020Reviewer(s) Assigned
08 Dec 2020Review(s) Completed, Editorial Evaluation Pending
11 Dec 20201st Revision Received
14 Dec 2020Submission Checks Completed
14 Dec 2020Assigned to Editor
18 Dec 2020Reviewer(s) Assigned
02 Jan 2021Review(s) Completed, Editorial Evaluation Pending
17 Mar 2021Editorial Decision: Accept
23 Mar 2021Published in International Journal of Clinical Practice. 10.1111/ijcp.14164