A Prospective Randomized Study Comparing Effectiveness of Local Anesthesia Techniques in Patients undergoing Transrectal Ultrasound-guided Prostate Biopsy.
- Author:
Seunghun SONG
1
;
Young Hwan JI
;
Sang Bok LEE
;
Dal san YOU
;
Jeong Kon KIM
;
Jong Yoen PARK
;
Han Jong AHN
;
Choung Soo KIM
Author Information
1. Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Prostate;
Biopsy;
Pain;
Local anesthetics
- MeSH:
Anesthesia, Local*;
Anesthetics, Local;
Biopsy*;
Hematuria;
Hemorrhage;
Hemospermia;
Humans;
Lidocaine;
Male;
Nerve Block;
Prospective Studies*;
Prostate*;
Seminal Vesicles;
Syncope, Vasovagal;
Urinary Retention
- From:Korean Journal of Urology
2004;45(3):236-239
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was designed to compare the effectiveness of intrarectal lidocaine gel versus periprostatic lidocaine injection during TRUS-guided biopsies. MATERIALS AND METHODS: From April 2003 to September 2003, 90 men undergoing a transrectal prostate biopsy were randomized into three groups. In group 1, 30 patients intrarectally received 20ml of 2% lidocaine gel; and group 2, 30 patients received 5ml(2.5ml per side) of 2% lidocaine solution injected along each side of the prostate, near the junction of the seminal vesicle and the base of the prostate(along the neurovascular bundles); in group 3, 30 patients received 5ml(2.5ml per side) of normal saline injected along the neurovascular bundles. The pain level after the biopsy was assessed using a 10-point linear visual analog pain scale(VAS). A statistical analysis was performed using the Wilcoxon Rank Sum test, and the results compared. RESULTS: Patient who received lidocaine solution injections along the neurovascular bundles (Group 2) had significantly lower VAS scores compared to the control group(mean score 3.56+/-2.13 versus 5.83+/-1.94, p<0.0001), but patients who received intrarectal lidocaine gel did not (mean score 5.46+/-2.70 versus 5.83+/-1.94, p=0.671). Gross hematuria, rectal bleeding and hemospermia occurred in 36(40.0%), 6(6.7%) and 5(5.6%) subjects, respectively. One patient had a vasovagal syncope. No patient reported febrile UTI or urinary retention. CONCLUSIONS: Bilateral nerve blockade with local anesthetic is a safe technique that significantly reduces pain during a prostate biopsy. However, in this study, intrarectal lidocaine injection did not reduce the pain compared to the control group during the prostate biopsy.
