[TRUS-guided biopsy: comparison of two anesthetic methods]

Area of Science:

• Urology
• Anesthesiology
• Pain Management

Background:

• Transrectal ultrasound-guided prostate biopsy is a common procedure for diagnosing prostate cancer.
• Pain and discomfort are significant concerns for patients undergoing prostate biopsy.
• Current analgesic techniques vary, with a need for more effective pain management strategies.

Purpose of the Study:

• To compare the efficacy of oral analgesia versus periprosthetic nerve blockade with mepivacaine for pain management during ultrasound-guided prostate biopsy.
• To assess patient-reported pain scores and the number of biopsy cores obtained with each technique.

Main Methods:

• A prospective randomized study involving 200 patients undergoing prostate biopsy.
• Group I received oral analgesia (metamizol, oral morphine).
• Group II received periprosthetic nerve blockade with 2% mepivacaine.
• Pain was assessed using a visual analogue scale (VAS) post-procedure.
• Statistical analysis was performed using the Student's t-test.

Main Results:

• Periprosthetic nerve blockade (Group II) resulted in significantly lower pain scores (95% reported no pain, VAS=0) compared to oral analgesia (Group I) (p < 0.05).
• Patients receiving periprosthetic nerve blockade had a higher average number of biopsy cores obtained (5 +/- 1.2) versus the oral analgesia group (3 +/- 1.3).
• No significant differences in major complications were observed between the groups.

Conclusions:

• Bilateral periprosthetic nerve blockade with mepivacaine is a highly effective and well-tolerated analgesic technique for prostate biopsy.
• This method significantly reduces procedural pain and discomfort.
• The technique also facilitates obtaining a greater number of biopsy cores, potentially improving diagnostic yield.