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Related Experiment Videos

Local anesthesia for prostate brachytherapy.

K Wallner1, C Simpson, J Roof

  • 1Radiation Oncology, Puget Sound Health Care System, Department of Veterans Affairs, Seattle, WA 98108-1597, USA.

International Journal of Radiation Oncology, Biology, Physics
|September 16, 1999
PubMed
Summary
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Prostate brachytherapy using only local anesthesia is a feasible technique. This method allows for a high-volume program without needing extensive operating room time, demonstrating its efficiency.

Area of Science:

  • Oncology
  • Urology
  • Anesthesiology

Background:

  • Prostate brachytherapy is a common treatment for localized prostate cancer.
  • Traditional brachytherapy often requires general or spinal anesthesia, which can limit program capacity and increase costs.

Purpose of the Study:

  • To demonstrate the technique and feasibility of performing prostate brachytherapy using local anesthesia exclusively.
  • To assess the safety and efficacy of this minimally invasive approach.

Main Methods:

  • Local anesthesia involved infiltrating the perineal skin, subcutaneous tissue, pelvic floor, and prostate apex with lidocaine.
  • Transrectal ultrasound (TRUS) guided needle insertion for brachytherapy seed placement.
  • Continuous monitoring of patient comfort and vital signs, with additional lidocaine administered as needed.

Related Experiment Videos

  • Total lidocaine dose generally limited to 500 mg.

    • Main Results:

    • Approximately 50 patients were successfully implanted using local anesthesia.
    • Moderate changes in heart rate and blood pressure indicated some patient discomfort.
    • Procedure times ranged from 35 to 90 minutes, with therapeutic serum lidocaine levels.
    • Low complication rates, including one instance of urinary retention and no unplanned admissions.

    Conclusions:

    • Local anesthesia is a viable and effective alternative for prostate brachytherapy.
    • This technique facilitates the rapid establishment of high-volume brachytherapy programs without significant operating room resource allocation.
    • Further research is exploring sedatives and analgesics to manage patient anxiety during the procedure.