Efficiency of intracavitary Levobupivacaine infusion for pain management
during cystoscopic procedures: A randomized study
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.