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Local anesthesia reduces pain associated with transrectal prostatic biopsy. A prospective randomized study
Alberto Trucchi1, Cosimo De Nunzio, Simone Mariani
1Urology Unit, Ospedale Sant'Andrea, II Faculty of Medicine, La Sapienza, University of Rome, Rome, Italy.
Urologia Internationalis
|April 7, 2005
Summary
Periprostatic block anesthesia significantly reduces pain during prostate biopsies compared to no anesthesia or lidocaine gel. This effective technique minimizes discomfort, with 65% of patients reporting no pain post-procedure.
Area of Science:
- Urology
- Pain Management
- Surgical Procedures
Background:
- Prostate biopsies are associated with significant patient discomfort and pain.
- Effective pain management strategies are crucial for improving patient tolerance of the procedure.
Purpose of the Study:
- To evaluate the efficacy of periprostatic block anesthesia in alleviating pain during transrectal ultrasound-guided prostate biopsy.
- To compare the pain scores of patients receiving periprostatic block with those receiving no analgesia or intrarectal lidocaine gel.
Main Methods:
- Randomized controlled trial with 1:1:1 allocation to no analgesia, intrarectal lidocaine gel, or transrectal periprostatic block.
- Visual analogue scale (VAS) used to quantify pain immediately after a 10-core biopsy.
- Statistical analysis using Kruskal-Wallis test.
Main Results:
- Periprostatic block group (n=20) reported significantly lower median VAS pain scores (0) compared to no analgesia (median 4) and lidocaine gel (median 4) groups (p=0.00001).
- 65% of patients receiving periprostatic block experienced no pain (VAS=0) post-biopsy.
- No major side effects were observed in any group.
Conclusions:
- Bilateral periprostatic block is a highly effective and well-tolerated method for managing pain associated with prostate biopsies.
- This technique significantly reduces or eliminates procedural pain and discomfort for patients.