The manuscript by Lucci et al. investigates the impact of lidocaine lubricant on autonomic dysreflexia (AD) during at-home bowel care in individuals with spinal cord injury (SCI) [1]. This paper was discussed with great interest in our laboratory journal club that comprised of trainees, researchers, and clinicians. We found the topic to be clinically relevant and important in the care of individuals with SCI as episodes of AD can potentially lead to serious cardiovascular consequences when left untreated. Bowel care is a challenging daily routine and a common trigger for AD, and presents a serious burden to individuals with SCI.

Lucci et al. employed a strong study design as a double-blind, placebo-controlled crossover clinical trial to examine the efficacy of commonly prescribed 2% Xylocaine lubricant prior to bowel care routine. Furthermore, the investigators utilized state of the art cardiovascular monitoring in order to examine the severity of AD (continuous beat-to-beat finger blood pressure and ECG monitoring). Finally, this study was pragmatically designed to mimic the real world by not standardising bowel care routines and thus reflecting the diversity of bowel care routines found in a community setting.

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