Bupivacaine provides rapid, effective periprostatic anaesthesia for transrectal prostate biopsy
J C Rabets1, J S Jones, A R Patel
1Glickman Urological Institute, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Objective:
To examine the effectiveness of the longer acting agent bupivacaine in providing periprostatic anaesthesia during transrectal ultrasonography (TRUS)-guided biopsy, as the periprostatic injection of lidocaine has been shown to significantly alleviate the pain of this procedure.
Patients And Methods:
Seventy-five patients were randomized to receive a periprostatic injection with either bupivacaine, a lidocaine/bupivacaine (1/1) combination, or no local anaesthesia. Immediately before biopsy 5 mL of the anaesthetic was injected under TRUS guidance into the periprostatic nerves bilaterally. After taking a 10-core biopsy the patients were given a visual analogue scale (VAS; 0-10) to assess their pain during the procedure.
Results:
The mean VAS scores were 2.04 in the bupivacaine group and 4.46 in the control (no local anaesthetic) group (P < 0.001).
Conclusions:
Bupivicaine provides significant, immediate periprostatic anaesthesia for TRUS biopsy.
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