Journal of endourology
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Journal of endourology · Jun 2001
Randomized Controlled Trial Clinical TrialRandomized trial of 10 mL and 20 mL of 2% intraurethral lidocaine gel and placebo in men undergoing flexible cystoscopy.
To determine if 20 mL of 2% intraurethral lidocaine gel is superior to 10 mL of 2% lidocaine or sterile lubricant for flexible cystoscopy in men. ⋯ Instillation of 20 mL or 10 mL of 2% lidocaine gel has no advantage over plain lubricant in providing anesthesia for flexible cystoscopy in men.
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Journal of endourology · Apr 2001
Randomized Controlled Trial Comparative Study Clinical TrialRandomized study of transurethral resection of the prostate and combined transurethral resection and vaporization of the prostate as a therapeutic alternative in men with benign prostatic hyperplasia.
In recent years, various minimally invasive alternatives to transurethral resection have become available for treatment of benign prostatic hyperplasia (BPH). Transurethral electrovaporization has become popular, with reported improvements in subjective and objectives measures, but a high rate of postoperative irritative symptoms and lack of tissue for histologic examination are the two most commonly reported disadvantages of this procedure. To decrease the postoperative irritative symptoms while minimizing intraoperative and postoperative bleeding and also to obtain tissue samples, we have combined the techniques of vaporization, which was termed "vapor-cut." The aim of this randomized study was to compare the efficacy and safety of vapor-cut with those of the gold standard, transurethral resection. ⋯ From our preliminary experience, vapor-cut seems to give results comparable to those of TURP. Because there is almost no bleeding during vapor-cut, the procedure is performed under excellent visibility, which permits more rapid and effective resection.
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Journal of endourology · Mar 2001
Randomized Controlled Trial Clinical TrialProspective double-blind study of effect of ketorolac administration after laparoscopic urologic surgery.
To decrease postoperative dependence on narcotics for analgesia, we have evaluated ketorolac as an adjunct to perioperative pain control in patients undergoing laparoscopic urologic surgery. ⋯ Ketorolac decreases the subjective perception of pain after laparoscopic urologic surgery. It is suggested that ketorolac administration decreases the amount of narcotic usage as well. Time to resumption of oral intake and length of hospital stay were not influenced by use of ketorolac.
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Journal of endourology · Oct 1996
Randomized Controlled Trial Clinical TrialPatient-controlled sedation and analgesia during SWL.
Sixty unpremedicated outpatients undergoing elective extracorporeal shockwave lithotripsy (SWL) using a Dornier MPL 9000 lithotripter were randomly assigned to receive either propofol-alfentanil (PA group; N = 30) or midazolam-alfentanil (MA group; N = 30) by a patient-controlled analgesia (PCA) device for sedation and analgesia. Although pain intensity scores were lower after 20 minutes and sedation was more pronounced in the MA group, both drug regimens produced satisfactory sedation and analgesia and allowed the maximum number of shockwaves to be given. Alfentanil consumption was less in the MA group (P < 0.05). ⋯ Patient satisfaction was very high with the two sedative-analgesic techniques. Propofol and midazolam, when given in combination with alfentanil using a PCA pump, may provide safe, effective analgesia and sedation during lithotripsy. Patient-controlled sedation and analgesia may provide optimal conditions for SWL of urinary tract stones and is a useful alternative to other forms of anesthesia and analgesia.