Age: "a natural anesthetic" in pain perception during the transrectal ultrasound-guided prostate biopsy procedure

The purpose of this study was to evaluate how the age factor might influence the tolerance biopsy examination, and then choose the modality of a local or general anesthetic technique.

This study evaluated 248 consecutive patients undergoing transrectal ultrasound-guided prostate biopsy for the first time. Each patient was treated under local anesthesia with lidocaine spray (10gr/100ml). Patients were divided into two groups according to age: Group A) 112 with age range ≤65 years, Group B) 136 with age range >65 years. Our first aim was to obtain a schedule of 14 biopsy samples in both groups. After the procedure each patient was given a verbal numeric pain scale (VNS), which was designed with 0 representing absence of pain and 10 the maximum pain they perceived in life.

The average pain assessed with VNS was around 4.2 (2-8) and 2.8 (0-6) for the patients in Group A and Group B, respectively. The two groups appeared to be homogeneous in terms of pain perception regarding PSA value and gland volume, and appeared to have different pain scores with regard to age. In fact, the first group of patients, with the same anesthetic technique used, perceived more intense pain sensations related to acute biopsy.

In conclusion, we can say that a local anesthetic in clinical practice in the course of prostate biopsy is more sensitive if performed in a person aged 65 years.