AN INSIGHTFUL, randomised clinical trial suggests that a simple, non-pharmacological nasal pressure technique may significantly reduce pain experienced by patients undergoing urinary catheterisation (UC) in the emergency department (ED).
Reducing Discomfort in Urinary Catheterisation with Nasal Pressure
Urinary catheterisation is one of the most frequently performed procedures in acute care settings and is commonly associated with discomfort. While pharmacological options exist, they are not always practical in emergency situations, highlighting the need for effective, low-cost alternatives. This study compared two non-pharmacological techniques to determine their effectiveness in reducing catheter-related pain.
The trial enrolled 54 male patients aged 18–65 years who required UC in the ED of Imam Khomeini Hospital. Participants were randomly allocated to one of three groups: Intervention Group 1, which used a nasal pressure technique combined with exhalation while keeping the epiglottis closed; Intervention Group 2, which used a deep cough technique during catheter insertion; and a control group that underwent routine UC without any additional intervention.
Pain intensity was measured using the Visual Analog Scale (VAS) at three time points: immediately before catheterisation, immediately after the procedure, and 15 minutes post-intervention. Statistical analyses were conducted using SPSS software.
Nasal Pressure Technique: A Practical Approach to Pain Management
The results showed that both intervention groups differed significantly from the control group in terms of pain intensity immediately after catheterisation. Patients in the nasal pressure group reported significantly lower pain scores compared with the control group, indicating a beneficial effect. In contrast, patients who performed the deep cough technique experienced higher pain levels than those in the control group at the same time point.
At 15 minutes post-procedure, pain scores in the nasal pressure group remained lower than in the deep cough group. Interestingly, the control group also reported lower pain scores than the deep cough group at this time point, although these differences did not reach statistical significance.
The authors suggest that the nasal pressure technique may activate physiological mechanisms that modulate pain perception. Importantly, the technique is simple, requires no equipment, and can be easily implemented in busy emergency settings.
The study concludes that nasal pressure during urinary catheterisation may be an effective non-pharmacological method for reducing procedural pain. However, the authors acknowledge limitations, including the small sample size and restriction to male patients, and call for larger studies to confirm the findings and assess broader clinical applicability.
If validated, this approach could represent a practical addition to routine urological care, improving patient comfort during a common and often uncomfortable procedure.
Reference
Sedaghati J et al. Comparison of the efficacy of two non-pharmacological techniques in reducing pain during urinary catheterization: a randomized clinical trial. BMC Urol. 2025;doi: 10.1186/s12894-025-02016-x
