I currently work in an Electrophysiology Lab where we routinely Foley patients requiring left sided heart procedures that necissitate the use of heparin. I am constructing a paper and developing best practice guidelines and looking for research, with minimal results. Any ideas on such historical research are appreciated.
Yes, Lubricating the urethra (preferentially by gentle injection via a 10 cc syringe) can reduce traumatic effect of catheterization in male, lidocaine gell %2 also helps to painless insertion provided that it be left at least 5 min before catheterzation. this lubrlcating process is not limited the "male" gender and should be applied for females also.
Thank you Manouchehr Amiri. Do you know of any published research or papers that support this - specifically the use of 2% gel. I remember reading somewhere that if it is allowed to dwell for >5 minutes it actually has the effect of helping the sphincter dilate. Now - of course, I cannot find the paper that this information was in.
I have a few more facts that might help. Some patients experience a stinging when lidocaine gel is inserted. Thompson et al suggest that cooling the gel prior to use, to 4°C helps this (REF: Thompson TJ, Thompson N, O'Brien A, Young MR, McCleane C, (1999) To determine whether the temperature of 2% lignocaine gel affects the initial discomfort which may be associated with its instillation into the male urethra). Kyle has discussed the different views on the use of lidocaine v. plain gel (REF: Kyle G (2011) Reducing urethral catheterization trauma with urethral gels. Br J Neuroscience Nurs 7(5 Suppl): S8-S12). In my own article I have pointed out the manufacturers' warnings re unwanted systemic uptake (which presumably would be more likely if there was bleeding). They advise caution when used in patients with impaired cardiac conditions, hepatic insufficiency and epilepsy (REF: Wilson 2012, Catheter lubrication and fixation: interventions. British Journal of Nursing, 2013, 22(10): 566-9). Tzortzis et al discuss repeated use and lidocaine absorption but perhaps your patients would not require repeated catheterisations (REF: Tzortzis V, Gravas S, Melekos MM, de la Rosette JJ (2009) Intraurethral Lubricants: A critical literature review and recommendations. J Endourol 23(5): 821-6). I hope these references are not too late for your paper. I might be able to help with other references if you need them. Good luck with it.
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