Effectiveness and safety of local anesthesia in patients with PI-RADS score 5 and ECOG score ≥2 for prostate puncture
10.3760/cma.j.cn112330-20220602-00333
- VernacularTitle:PI-RADS评分5分且ECOG评分≥2分患者前列腺穿刺中应用局麻的效果和安全性
- Author:
Yuexing HAN
1
;
Xuefei DING
;
Yang LUAN
;
Liangyong ZHU
;
Shengming LU
;
Tianbao HUANG
;
Haopeng CHEN
;
Xiao TAN
;
Zhenhao WU
;
Yueqi WU
Author Information
1. 江苏省苏北人民医院泌尿外科，扬州 225001
- Keywords:
Prostatic neoplasms;
Perineal;
Prostate puncture;
Local anesthesia
- From:
Chinese Journal of Urology
2023;44(2):97-101
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of local anesthesia in patients with a PI-RADS score of 5 and ECOG score ≥2 for prostate puncture.Methods:Retrospective analysis of case data of 33 patients admitted to the Subei People's Hospital for prostate puncture from April 2020 to April 2022. Age (82.5±3.6) years. There were 18 cases with hypertensive disease, 8 cases with diabetes mellitus, and 6 cases with both diabetes mellitus and hypertensive disease. Body mass index (25.2±3.5) kg/m 2. prostate-specific antigen (PSA)(131.5±69.7) ng/ml. prostate volume (38.5±21.4) ml. all patients had a PI-RADS score of 5 on multiparametric magnetic resonance (mpMRI) and an Eastern Cooperative Oncology Group (ECOG) score ≥2. All 33 cases in this group underwent trans-perineal targeted prostate puncture using local anesthesia at the tip of the prostate. The visual analog score (VAS) and visual numeric score (VNS) were applied by the same surgeon to assess the patient's pain level and satisfaction at the time of puncture (VAS-1 and VNS-1) and 30 min after puncture (VAS-2 and VNS-2), and to record the duration of the procedure and the occurrence of postoperative complications. Results:In this group of 33 cases, the VAS-1 score was (1.9±0.3) and the VAS-2 score was (0.1±0.2); the VNS-1 score was (2.9±0.2) and the VNS-2 score was (3.9±0.1). Postoperative pathological results indicated that one of the 33 patients had a negative puncture result (pathology report indicating interstitial inflammation), while the rest of the patients had a positive puncture pathology report (puncture pathology report indicating prostate cancer), with a positive rate of 97%. One case of postoperative carnal haematuria occurred, which gradually improved after the patient was advised to drink water and take alpha-blockers. No perineal hematoma occurred, and all patients did not suffer complications such as urinary tract infection, urinary retention, azoospermia, vagal reaction, and infectious shock.Conclusion:In patients with a PI-RADS score of 5 and ECOG score ≥2, the use of single-hole local anesthesia for performing trans-perineal targeted puncture biopsy has the advantages of good paroxysmal pain and high safety.
