Alkalinized lidocaine solution as a first-line local anesthesia protocol for intradetrusor injection of onabotulinum toxin A: Results from a double-blinded randomized controlled trial.
Administration, Intravesical
Adult
Aged
Aged, 80 and over
Anesthetics, Local
/ administration & dosage
Botulinum Toxins, Type A
/ administration & dosage
Double-Blind Method
Female
Humans
Lidocaine
/ administration & dosage
Male
Middle Aged
Pain
/ drug therapy
Pain Measurement
Urinary Bladder, Neurogenic
/ drug therapy
Urological Agents
/ administration & dosage
administration, intravesical
anesthesia, local
botulinum toxins, type A
double-blind method
lidocaine
randomized controlled trial
sodium bicarbonate
urinary bladder, overactive
Journal
Neurourology and urodynamics
ISSN: 1520-6777
Titre abrégé: Neurourol Urodyn
Pays: United States
ID NLM: 8303326
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
02
05
2020
revised:
11
08
2020
accepted:
09
09
2020
pubmed:
22
9
2020
medline:
9
3
2021
entrez:
21
9
2020
Statut:
ppublish
Résumé
Local anesthesia protocols for intradetrusor onabotulinum toxin A (BoNTA) injection lack standardization. We aimed to determine if an alkalinized lidocaine solution is more effective than lidocaine only. Patients of both genders aged 18 or above enlisted for intradetrusor BoNTA injection (idiopathic, neurogenic, and bladder pain syndrome) were included in a double-blinded randomized controlled trial after obtaining their informed consent. All participants filled a bladder diary and a urine culture was performed. Subjects were randomized 1:1 to Protocol A (20 ml 2% lidocaine + 10 ml 8.4% sodium bicarbonate) or Protocol B (20 ml 2% lidocaine + 10 ml 0.9% saline solution). A Numeric Rating Scale (0-10) was used to assess the level of pain immediately after the procedure (primary endpoint). Secondary endpoints included pain after 1 h, urinary tract infection, acute urinary retention, and hematuria related to the procedure. A total of 116 patients were randomized. Baseline characteristics (age, sex, indication, and bladder diary parameters) of patients in Group A and B were similar. Pain scores at the end of the procedure were significantly lower with the alkalinized solution (Protocol A and B, respectively, 2.37 ± 0.31 vs. 4.44 ± 0.36, p < .01). No differences were observed 1 h after treatment (Protocol A and B, respectively, 0.54 ± 0.17 vs. 0.69 ± 0.19, p = .487). The only adverse event reported was mild-to-moderate self-limited hematuria in 15.4% of patients. The use of an alkalinized lidocaine solution has proven to be significantly superior to lidocaine only as local anesthesia before intradetrusor BoNTA injection, suggesting that this may be considered a first-line option.
Substances chimiques
Anesthetics, Local
0
Urological Agents
0
Lidocaine
98PI200987
Botulinum Toxins, Type A
EC 3.4.24.69
onabotulinum toxin A
EC 3.4.24.69
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
2471-2479Informations de copyright
© 2020 Wiley Periodicals LLC.
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