Chua ME, et al. - The efficacy and safety of lidocaine gel were compared with nonanesthetic gel (NAG) in reducing transurethral bladder catheterization (TUBC) procedural pain in children. Results revealed that lidocaine gel did not seem to reduce TUBC pain compared with NAG, specifically in children aged <4 years.

Methods

• This study was conducted with the aid of electronic medical databases and trial registries up to September 2016 with no language restrictions.
• The authors screened, identified, and appraised the randomized controlled trials (RCTs) that evaluated the efficacy and safety of lidocaine gel vs NAG in reducing TUBC-associated pain in children.
• According to the Cochrane Collaboration recommendations, risks of bias and study quality of the eligible trials were evaluated.
• Various pain assessment scales from the included studies were extracted as mean differences and standard deviations for each treatment group. 
• Standardized mean differences (SMDs) were generated with 95% CIs for between-group difference estimation.
• Using inverse variance method with a random-effects model, effect estimates were pooled.
• For different age groups, subgroup analysis was performed.

Results

• 5 RCTs (with a total of 369 children) were selected. 
• Overall pooled effect estimates showed that compared with NAG, lidocaine gel has no significant benefit in decreasing TUBC-associated pain in children (SMD, -0.22; 95% CI, -0.65 to 0.21).
• Effect estimates from 4 studies revealed no difference in pain reduction between the lidocaine gel and NAG in children aged <4 years (SMD, 0.01; 95% CI, -0.22 to 0.24). 
• In any of the studies, no serious adverse events from the lidocaine gel use were reported.