Lidocaine-prilocaine cream reduces catheter-related bladder discomfort in male patients during the general anesthesia recovery period: A prospective, randomized, case-control STROBE study.

Urethral catheterization is a predictor of agitation during the general anesthesia recovery period. The aim of this study was to determine the effect of intraurethral 5% lidocaine and 25 mg/g prilocaine cream in reducing catheter-related bladder discomfort (CRBD) in male patients during the general anesthesia recovery period. Adult male patients undergoing elective operations that required urinary catheterization under general anesthesia were enrolled and assigned randomly to 2 groups. In the lidocaine-prilocaine cream group (n = 72), approximately 5 g of topical cream was spread in the preputial sac, the glans, the meatus, and on the urinary catheter surface before urinary catheterization. In the control group (n = 74), the urinary catheter was lubricated with lidocaine gel. The incidence and severity of CRBD were assessed 15, 30, 45, and 60 minutes postoperatively. We found that the incidence of CRBD in the lidocaine-prilocaine cream group was significantly lower than in the control group. Multivariate logistic regression analysis showed that lidocaine-prilocaine cream applications reduced moderate or severe CRBD. Thirty minutes postoperation was the most frequent time point for the incidence of CRBD. Application of lidocaine-prilocaine cream on the surface of the urinary catheter is an efficient and safe method to reduce the incidence and severity of CRBD.

Preemptive submucosal infiltration with ropivacaine for uvulopalatopharyngoplasty.

OBJECTIVE: To evaluate the preemptive analgesic effect of submucosal infiltration of ropivacaine for uvulopalatopharyngoplasty. STUDY DESIGN: Randomized controlled trial. SETTING: Comprehensive clinical center and academic hospital. SUBJECTS AND METHODS: Fifty consecutive male patients scheduled for uvulopalatopharyngoplasty were divided randomly into group A and group B. In group A, 4 mL of 0.33% ropivacaine and normal saline with epinephrine was preincisionally injected under the mucosa on both sides of the tonsillar fossa, soft palate, and the lower part of palatoglossal arch, whereas the upper and middle parts of the palatoglossal arch and the upper part of the palatopharyngeal arch were infiltrated with 2 mL of the same mixture. In group B, an identical volume of normal saline with epinephrine was administered. In both groups, postoperative pain was initially controlled by intravenous morphine titration until patient-controlled analgesia with morphine could be used. Cumulative patient-controlled analgesic morphine consumption; visual analog scale scores at 4, 8, 12, 24, and 48 hours postoperatively at rest and during swallowing; and opioid-related adverse effects were recorded. RESULTS: The visual analog score was lower at rest during the 48-hour postoperative period and during swallowing within the first 12 hours for group A versus group B (P < .05). Patients in group A required 44.1%, 38.2%, and 41.1% less morphine during the first 24 hours, 24 hours to 48 hours, and 48 hours postoperatively, respectively, and fewer patients experienced nausea, vomiting, and pruritus (P < .05). CONCLUSION: Preemptive submucosal infiltration with 0.33% ropivacaine effectively controlled pain after uvulopalato-pharyngoplasty.

A chin-lift mask produces a patent airway more effectively than an oropharyngeal airway using the EC-clamp technique in obese patients.

OBJECTIVE: To evaluate the efficiency of ventilation using a novel chin-lift mask compared with an oropharyngeal airway (OPA) with EC-clamp technique in obese patients. METHODS: Obese patients scheduled for cholecystectomy under general anaesthesia were divided into two groups: the OPA group, in which a standard mask and OPA with the EC-clamp technique were used; the CL group, in which the chin-lift mask was used. Respiratory data were compared. RESULTS: One hundred patients were recruited and assigned to the OPA (n = 50) and CL (n = 50) groups. Compared with the OPA group, expired tidal volume, peripheral oxygen saturation (SpO2), tidal volume/peak inspiratory pressure ratio and end-tidal carbon dioxide were higher, and the peak and mean inspiratory pressures were lower, in the CL group. In the CL group, no patient had an SpO2 ≤ 95% and the lowest SpO2 was 99%, whereas in the OPA group, 23 patients had an SpO2 ≤ 95% and the lowest SpO2 was 92%. Difficult mask ventilation occurred in eight patients in the OPA group but in none in the CL group. CONCLUSION: The chin-lift mask provided a patent airway and better quality mask ventilation than an OPA with EC-clamp technique in obese patients.