Xylocaine for foley catheterization in males

[deannaZ]

I am working on a new policy for catheterization in my hospital. We are currently debating whether or not to ROUTINELY use Xylocaine for every catheterization on a male. I cannot find anything definitive in the literature. I know that Xylocaine is often used. I checked with the two tertiary urology wards where the nurses catheterize males quite frequently, including males with prostate disease, who tell me that Xylocaine is not routinely used due to the risk of urethral injury/creation of a false pasage/fistula etc. They tell me that 10 cc of muco in the catheter is as effective and decreases the risk of injury, due to the loss of sensation during catheterization.

Can people tell me what is routine practice and in the policies of your facilities?

Thanks!

[Farkinott, RN]

I think women don't get lignocaine pre foley insertion due to the short urethra. Males on the other hand have a bit more distance to travel! If it was me getting catheterised I would want about 10 litres of lignocaine!

[ayla2004, ASN, RN]

we use installjel on anyone getting a catheter its lidocaine in ky jelly

[sjt9721, BSN, RN]

I think women don't get lignocaine pre foley insertion due to the short urethra. Males on the other hand have a bit more distance to travel!...

And some males have more distance than others... :smilecoffeecup:

[btaylor569]

I helped set up a P&P at a hospital several years ago, staff was using xylocaine gel for foley and NG insertions, without any P&P.

Now the hospital has moved it into it's order set for insertion orders.

True, xylocaine is not immediatly effective both for this and for IV insertions. If you want things to be numb before insertion, you need to infuse the xylocaine and wait about 5 minutes. Otherwise, if you don't wait, there will still be some level of stimulation/pain/discomfort. But as articles have indicated, whether you wait or not, once it is effective, you'll have about 1-2 hours of comfort, post procedure. Which for those getting IV's, foleys, and/or NG's inserted for surgery, then in many cases, the client won't be climbing out of your stretcher as they are waking up, c/o the need to void!!!! Most times, all they need is the 1-2 hour window for their body to be adjusted to having an IV, foley, NG, whether it got inserted awake or asleep. Just make sure that the xylocaine you use for the foley is sterile!! For NG insertion it is not important for it to be sterile and can be viscous style for the nose, clears better post procedure.

Also, if building order sets, remember "caine" allergy exclusion!!

Good luck, your men, and women, will be very greatful!