Prospective Comparison Among Three Intrarectal Anesthetic Treatments Combined with Periprostatic Nerve Block During Transrectal Ultrasonography-guided Prostate Biopsy

Overview

Journal World J Urol

Specialty Urology

Date 2017 Nov 25

PMID 29170792

Citations 3

Authors

R A Valdez-Flores

J G Campos-Salcedo

J J Torres-Gomez

A Sedano-Lozano

J Pares-Hipolito

L M Shelton

A Canizalez-Roman

M A Valdez-Flores

Affiliations

Soon will be listed here.

Abstract

Background: Recent trends in prostate biopsy analgesia suggest a combination anesthetic to provide better pain relief than periprostatic nerve block (PPNB) alone. This study aimed to demonstrate the efficacy and safety of three intrarectal local anesthesia (IRLA) combined with PPNB in patients undergoing transrectal ultrasonography (TRUS)-guided prostate biopsy.

Methods: In this prospective, randomized study, 120 prostate biopsy patients were equally divided into four IRLA groups: group 1 (placebo) received simple lubrication; group 2 received 2% lidocaine gel; group 3 received 100 mg indomethacin suppository and group 4 received 5% prilocaine/lidocaine (EMLA) cream. PPNB with 2% lidocaine was applied in all groups. A ten-point visual analog scale evaluated both pain associated with the probe insertion and pain associated with prostate sampling. Adverse effects or complications due to anesthesia during and after the procedure were documented.

Results: Compared with group 1, groups 3 and 4 had significantly lower pain scores at both probe insertion and prostate sampling while group 2 showed no significant differences at both pain scores. Moreover, group 4 showed significantly lower pain scores at probe insertion compared to group 3, while no significant difference was observed at prostate sampling. Mild complications were observed in all groups with no significant difference in the incidence of complications between groups.

Conclusion: Intrarectal application of EMLA cream is a more efficient pain reduction than either 2% lidocaine gel or 100 mg indomethacin suppository when applied combined with PPNB. This combination represents an effective option of pain relief for patients undergoing TRUS-guided prostate biopsy.

Citing Articles

Lower Dose of 5 mL of 1% Lidocaine is More Suitable than the Conventional 10 mL for Caudal Block in Transrectal Prostate Biopsy: A Retrospective Cohort Study.

Ueda N, Sato M, Mori S, Matsukawa A, Oki Y, Kujime Y Adv Urol. 2024; 2024:9331738.

PMID: 38389652 PMC: 10881246. DOI: 10.1155/2024/9331738.

Current Approach to Complications and Difficulties during Transrectal Ultrasound-Guided Prostate Biopsies.

Osama S, Serboiu C, Taciuc I, Angelescu E, Petcu C, Priporeanu T J Clin Med. 2024; 13(2).

PMID: 38256621 PMC: 10816968. DOI: 10.3390/jcm13020487.

Comparison of pain levels in fusion prostate biopsy and standard TRUS-Guided biopsy.

Demirtas A, Sonmez G, Tombul S, Demirtas T Int Braz J Urol. 2020; 46(4):557-562.

PMID: 32213209 PMC: 7239274. DOI: 10.1590/S1677-5538.IBJU.2019.0154.

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