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Periprostatic Nerve Block During Transperineal Prostate Biopsy Under General Anaesthesia: Protocol for a Multicentre

Basil Razi1, Cheryl Fung1, George McClintock2

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|May 4, 2026
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Summary

Periprostatic nerve block (PPNB) did not significantly reduce early post-operative pain or analgesic needs in men undergoing transperineal prostate biopsy (TPPB) under general anaesthesia in this pilot study.

Keywords:
anaesthesiaperiprostatic nerve blockpost-operative painprostate biopsyprostate cancerrandomised controlled trialvisual analogue scale

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Area of Science:

  • Urology
  • Anesthesiology
  • Surgical Oncology

Background:

  • Transperineal prostate biopsy (TPPB) is preferred for prostate cancer detection due to improved apical sampling and reduced sepsis risk.
  • TPPB under general anaesthesia commonly results in early post-operative pain.
  • The efficacy of periprostatic nerve block (PPNB) as an adjunct to general anaesthesia for TPPB pain is not established.

Purpose of the Study:

  • To evaluate if PPNB reduces early post-operative pain following TPPB under general anaesthesia.
  • To assess the impact of PPNB on analgesic requirements after TPPB.

Main Methods:

  • A multicentre, double-blind, randomised controlled trial (RCT) comparing PPNB with lignocaine versus placebo.
  • Men undergoing TPPB under general anaesthesia were randomised 1:1 to receive PPNB or placebo.
  • Primary endpoint: post-operative pain via visual analogue scale; Secondary endpoints: analgesic consumption, complications, procedure duration, core number.

Main Results:

  • PPNB did not significantly reduce visual analogue scale pain scores prior to discharge.
  • No significant difference was observed in analgesic consumption between the PPNB and placebo groups.
  • Complication rates, procedure duration, and biopsy core numbers were similar between groups.

Conclusions:

  • PPNB, as an adjunct to general anaesthesia, did not effectively reduce early post-operative pain or analgesic requirements in TPPB.
  • Further research may be needed to explore alternative pain management strategies for TPPB under general anaesthesia.