A combination of Intrarectal Lignocaine Cream Plus Periprostatic Nerve Block Improves Pain Control in Transrectal Ultrasound Guided Prostate Biopsy: a Prospective Evaluation. | [Anaesthesia, Pain and Intensive Care • 2018]

Author(s):

1. Ekrem Akdeniz: Health Sciences University, Samsun Training and Research Hospital, Department of Urology, Samsun, Turkey

2. Sevda Akdeniz: Health Sciences University, Samsun Training and Research Hospital, Department of Anesthesia and Reanimation, Samsun, Turkey

Abstract:

Prostate biopsy is a painful procedure. The aim of this study was to University, Samsun Training and determine which stage of prostate biopsy is most painful and to investigate the effect of Research Hospital, Department intrarectal local anesthetic (IRLA) on the periprostatic nerve block (PNB). of Urology, Samsun, (Turkey); E-mail:ekrem.akdeniz@saglik. Methodology: Two groups were established in this prospective, randomized controlled gov.tr tsudy. One received ultrasonic gel + prilocaine during PNB (Group UP) and the other 2Anehstetist, Health Sciences received intrarectal lignocaine gel + prilocaine combination (Group IP). Prior to probe University, Samsun Training and insertion, ultrasonic gel only was applied to the patients in Group UP, while the Research Hospital, Department subjects in Group IP were administered 60 mg of lignocaine gel via the rectal route 5 of Anesthesia and Reanimation, min before the biopsy procedure. In the subsequent stage, 10 ml of 2% prilocaine was Samsun, (Turkey); E-mail: sevda. infiltrated 4 ml into each prostate-seminal vesicle junction and 2 ml into the apex of the akdeniz@saglik.gov.tr prostate. Pain evaluation during and after biopsy was explained to the patients, and this assessment was performed using a Visual Analog Scale (VAS). Results: The mean age of the patients was 63.37 ± 6.61 years. We identified probe insertion as the most painful stage of prostate biopsy. VAS scores during probe insertion were 3.63 ± 0.98 in Group UP and 3.35 ± 0.85 in Group IP (p = 0.001). We observed less pain in patients receiving an IRLA + PNB combination during biopsy (p = 0.001). Conclusions: Probe insertion is the most painful stage in transrectal ultrasonography guided prostate biopsies, and intrarectal local anesthetic significantly reduces probe insertion-related pain. In addition, a combination of intrarectal local anesthetic and periprostatic nerve block causes less pain than ultrasonic gel and periprostatic nerve block during biopsy.

Page(s): 8-15

DOI: DOI not available

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 22, Issue: 1, Year: 2018

Keywords:

pain , Probe , Lignocaine , Prostate , Transrectal prostate biopsy , Periprostatic nerve block

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