Urinary Tract Infection Clinical Trial
Official title:
A Randomized Blinded Controlled Trial of 2% Lidocaine Gel Compared to Standard of Care in Children Undergoing Urethral Catheterization
Children 0-24 months of age requiring a urethral catheterization for urine collection will be randomized to receive either topical and intraurethral 2% lidocaine or standard of care to assess for the effectiveness of the former in minimizing pain during urethral catheterization. It is hypothesized that administration of 2% lidocaine gel both topically and intraurethrally will confer a greater degree of pain reduction compared to standard of care.
An estimated 10% of children 0-24 months of age that present to the emergency department
(ED) with fever and/or vomiting have a urinary tract infection (UTI). An accurate diagnosis
of a UTI ensures timely and appropriate treatment given to reduce the risk of renal
scarring, which is the greatest in this age group. To ensure diagnostic accuracy, urethral
catheterization is the preferred method to obtain a urine sample from a young child. In
contrast to adults, most children do not receive local analgesia for urethral
catheterization; despite growing recognition that children experience avoidable pain and
discomfort during invasive procedures.
Following informed consent, participants will be randomized by block randomization in a
concealed fashion to receive either topical and intraurethral 2% lidocaine or standard of
care using a computerized random number generator. The research nurse will access a
sequentially numbered, opaque sealed envelope that will contain the participant's group
assignment. No adjunctive analgesic methods will be used. A research pharmacist will prepare
2% lidocaine gel in a 3 cc syringe attached to a 24 gauge angiocath. Children < 7 kg and > 7
kg will receive 1 cc and 1.5 cc, respectively (2).
The entire procedure will be videotaped and participants pain will be scored using a brow
bulging score and visual analogue scale by independent, blinded raters.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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