COMPARISON OF PAIN INTENSITY BETWEEN LIDOCAINE GEL AND INTRAURETRAL TRAMADOL WITH LIDOCAINE GEL IN THE DJ STENT REMOVAL
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Abstract
Objective: To determine the difference in pain intensity between the administration of a combination of tramadol and intraurethral lidocaine gel with only lidocaine gel during the removal of DJ stents. Material & Methods: This study was a prospective randomized clinical trial with 22 patients that were divided into 2 groups. Group 1 was given a combination of tramadol and lidocaine gel urethral injection 3 to 5 minutes before DJ stent removal, whereas group 2 was given lidocaine gel urethral injection 3-5 minutes before the removal. The inclusion criteria in this study was all patients with a DJ stent placement with 1 to 3 months prior to release who were willing to participate. The Wong-Baker scale was used directly to determine the scale of pain during the procedure. Mann Whitney analysis was used to analyze the findings. Results: Most patients in group 1 are shown to have a pain rating of 2. There are 2 patients with a high pain rating scale of 6 and 7. In group 2, most patients claimed that the procedure was painless. The average Wong-Baker pain scale in group 1 (2.9) compared to group 2 (0.36) was significantly different. Conclusion: The combination of intraurethral tramadol and 2% lidocaine gel can significantly decrease pain during DJ stent removal more effectively than sole intraurethral 2% lidocaine gel based on the Wong-Baker pain scale.
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Lidocaine, Tramadol, DJ stent, pain
Ricardo Miyaoka MM. Ureteral stent discomfort: Etiology and management. Indian J Urol. 2009;25(4):455–60.
Liatsikos E. Long Term Stenting of the Ureter. In: Tanagho EA, McAninch JW, editors. Smith`s General Urology. 17th ed. 2008. p. 278–96.
Tailly T, Denstedt JD. Fundamentals of Urinary Tract. In: Kavoussi LR, Partin AW, Peters CA, Wein AJ, editors. Campbell-Walsh Urology. 11th ed. 2016. p. 126–32, 153–80.
WolfJr J, Roberts WW, Ambani S, Anna Silvenis R. Frequently Asked Questions about Ureteral Stents. Univ Michigan Heal Syst. 2016;1–4.
Oswal AT, Maheshwari PN, Amlani D. Cystoscopic stent removal using a guidewire loop. Indian J Urol. 2017;33(3):253–4.
Kim JH, Park SY, Kim MG, Choi H, Song D, Cho SW, et al. Pain and satisfaction during rigid cystoscopic ureteral stent removal : a preliminary study. BMC Urol. 2014;14(90):1–6.
Loh-doyle JC, Low RK, Monga M, Nguyen MM. Patient Experiences and Preferences. J Endourol. 2015;29(1):35–40.
Stein M, Lubetkin D, Taub HC, Skinner WK, Haberman J, Kreutzer ER. The Effects Of Intraurethral Lidocaine Anesthetic And Patient Anxiety On Pain Perception During Cystoscopy. J Urol. 1994;151(6):1518–21.
Liebert MA, Farlane NMC, Denstedt J, Ganapathy S, Razvi H. Lidocaine Gel and Placebo in Men Undergoing Flexible Cystoscopy. 2001;15(5).
Demir E, Kilciler M, Bedir S, Erken U. Patient Tolerance during Cystoscopy : A Randomized Study Comparing Lidocaine Hydrochloride Gel and Dimethyl Sulfoxide with Lidocaine. 2008;22(5).
Grond S, Sablotzki A. Clinical Pharmacology of Tramadol. 2004;43(13):879–923.
Khajavi M, Moharari RS, Najafi A, Kazemi H, Ostovar A, Khashayar P. Intraurethral tramadol alleviates rigid cystoscopy-related pain in men. 2013;
Karthikeyan VS, Keshavamurthy R, Chandrashekar CR. Efficacy of preprocedural diclofenac in men undergoing double J stent removal under local anesthesia : A double-blind , randomized control trial Abstract Introduction : Methods : Results : Conclusions : Indian J Urol. 2017;33(1):5–9.
Ahmad I, Pansota MS, Tariq M, Saleem MS, Tabassum SA, Hussain A. Comparison Between Double J ( DJ ) Ureteral Stenting and Percutaneous Nephrostomy ( PCN ) in Obstructive Uropathy. Pak J Med Sci. 2013;29(3):725–9.
Ozgur BC, Ekıcı M, Yuceturk CN, Bayrak O. ScienceDirect Bacterial colonization of double J stents and bacteriuria frequency. Kaohsiung J Med Sci. 2013;29(12):658–61.
Kose O, Gorgel SN, Ozbir S, Yenigurbuz S, Kara C. Manual Replacement of Double J Stent (Double J stent replacement). Int Surg. 2015;100:381–5.
Abdelaziz AY, Fouda WB, Mosharafa AA, Abelrasoul MA, Fayyad A, Fawzi K. Forgotten ureteral stents : Risk factors , complications and management. African J Urol. 2018;24(1):28–33.
Shigemura K, Yasufuku T. How long should double J stent be kept in after ureteroscopic lithotripsy ? Urol Res. 2012;40:373–6.
Nerli R, Magdum P, Ak Guntaka. Forgotten/retained double J ureteric stents: A source of severe morbidity in children Rajendra. African J Paediatr Surg. 2016;13(1):1–4.
Milicevic S, Bijelic R, Jakovljevic B. Encrustation of the Ureteral Double J Stent in Patients with a Solitary Functional Kidney – a Case Report. Med Arh. 2015;69(4):265–8.
Onwuasoanya DA. Pain Management and Assessment for Healthcare Practitioners : Review Article. J Anesth Pain Med. 2016;1(2):1–4.
Mimic A, Dencic N, Jovi J, Mirkovi J, Milenkovi D. Pre-Emptive Tramadol Could Reduce Pain after Ureteroscopic Lithotripsy. Yonsei Med J 55(5)1436-1441,. 2014;55(5):1436–41.
Cavalli AC, Filho RT, Slongo LE, Cavalli RC, Rocha LC de A. The use of double-J catheter decreases complications of retroperitoneoscopic ureterolithotomy. Rev Col Bras Cir. 2012;39(2):112–8.