Pain during rigid cystoscopy: a prospective randomized controlled study comparing the benefit of cooled and room temperature lignocaine gel

Lignocaine gel is an established topical anesthetic agent for cystoscopy in awake patients. We performed a prospective randomized study to evaluate whether cooling the lignocaine gel to 4°C decreases the pain perception during cystoscopy in male patients. Sixty consecutive male patients undergoing rigid cystoscopy were randomized into two groups. Group I received 15 ml of 2% lignocaine hydrochloride gel at 4°C and group II received the same agent at room temperature (20°C). Cystoscopy was performed and pain perceived during the procedure was assessed by independent evaluator using Wong-Baker FACES pain scale rating chart. The mean pain score in group I was lower (4.32±1.70) than that in group II (5.28±1.99), but this difference was statistically not significant (p=0.191). However significantly greater percentage (84% Vs 52%) of patients with cooled lignocaine wished to have same anesthetic in future for similar procedure (p=0.032). In conclusion, cooling the lignocaine gel to 4°C does not decrease the pain perception during rigid cystoscopy in male patients.