Prospective comparison among three intrarectal anesthetic treatments combined with periprostatic nerve block during transrectal ultrasonography-guided prostate biopsy
| Autor: | A. Sedano-Lozano, Adrian Canizalez-Roman, R. A. Valdez-Flores, Luke M. Shelton, J. G. Campos-Salcedo, J. J. Torres-Gomez, J. Parés-Hipólito, Marco A. Valdez-Flores |
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| Rok vydání: | 2018 |
| Předmět: |
Image-Guided Biopsy
Male Prostate biopsy Lidocaine Visual analogue scale Administration Topical Urology medicine.medical_treatment Indomethacin 030232 urology & nephrology Pain Procedural Prilocaine Endosonography 03 medical and health sciences Prostate cancer 0302 clinical medicine medicine Humans Local anesthesia Anesthetics Local Lidocaine Prilocaine Drug Combination Aged Pain Measurement medicine.diagnostic_test business.industry Anti-Inflammatory Agents Non-Steroidal Prostate Rectum Nerve Block Middle Aged medicine.disease Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11] 030220 oncology & carcinogenesis Anesthesia Nerve block Transrectal ultrasonography Biopsy Large-Core Needle business Anesthesia Local medicine.drug |
| Zdroj: | World Journal of Urology, 36, 2, pp. 193-199 World Journal of Urology, 36, 193-199 |
| ISSN: | 0724-4983 |
| DOI: | 10.1007/s00345-017-2136-z |
| Popis: | Item does not contain fulltext 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. 01 februari 2018 |
| Databáze: | OpenAIRE |
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