Electromotive drug administration of lidocaine as an alternative anesthesia for transurethral surgery

Purpose: A multicenter study was undertaken to evaluate the safety, efficac y and cost of electromotive drug administration of intravesical lidocaine t o produce bladder local anesthesia as an alternative to traditional methods of spinal or general anesthesia. Materials and Methods: A total of 94 patients were enrolled in the study wh o had either a history of bladder tumor that required cold cup bladder biop sy with fulguration for possible recurrence as a comparison trial, a bladde r tumor treated with transurethral resection/fulguration oil benign prostat ic hyperplasia/carcinoma treated with transurethral resection. Pain scores using a Verbal Rating Scale were recorded for each individual biopsy, fulgu ration and resection event. Data for direct and indirect costs were collect ed using a standardized form for each patient to capture the details of the procedure, including times, drugs and disposables for each patient. Results: There was a significant reduction in pain for patients who receive d electromotive intravesical lidocaine compared to no anesthesia for biopsy (p < 0.03). Similarly, electromotive intravesical lidocaine for bladder bi opsy and transurethral bladder tumor resection/fulguration was associated w ith higher patient satisfaction compared to previous treatments (p < 0.0000 2). In contrast, electromotive intravesical lidocaine was insufficient for 3 of 6 transurethral prostatic resections. The cost per patient was about $ 146 Cdn less with electromotive intravesical lidocaine than with convention al general/spinal anesthesia. Conclusions: Electromotive intravesical lidocaine may be a safe, effective and affordable form of anesthesia for the ambulatory care of patients requi ring transurethral bladder biopsy, resection or fulguration with a potentia l for cost savings.