Bilateral Fine-Needle Administered Local Anaesthetic Nerve Block for Pain Control during TRUS-Guided Multi-Core Prostate Biopsy: A Prospective Randomised Trial

Knobloch, Rolf von; Weber, J.; Varga, Zoltán; Feiber, Helmut; Heidenreich, Axel; Hofmann, Rainer

doi:10.1016/s0302-2838(02)00072-6

Cited by 74 publications

(60 citation statements)

References 17 publications

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“…No difference in median number of days (LA vs. CT) of hematuria (2.6 vs 2.3), hematochezia (0.55 vs. 0.36), and hematospermia (0.65 vs. 0.69). Knobloch [41] No complications related to injection. No impact on cancer detection rate (LA = 50%, CT = 47.1%).…”

Section: Intrarectal Lignocainementioning

confidence: 97%

“…[34][35][36]42,44,[51][52][53]19,56 They were not specified in the remaining 15 trials. 14,[37][38][39][40][41]43,[45][46][47][48][49][50]54,55 For the trials assessing the efficacy of PPNBs, two types of controls were used. Either no anesthesia at all was given or an equivalent volume of normal saline injection was administered.…”

Section: Study Description and Validitymentioning

confidence: 99%

“…For the 10 trials with placebo injections, concealment of allocation was judged to be adequate with central office randomization in six studies, 35,42,46,55,19,56 but was not used or unclear in the remaining four. 14,40,47,48 For these 10 studies, there was also concern that normal saline placebo injections may cause additional injection-related pain 41 and pain scores from placebo injections alone had been measured to be between 1.1 and 1.8. 51 To address this issue, both types of study controls (no anesthesia as well as placebo injection) were used in two of the studies and no significant difference was found between the mean pain scores of the placebo injection groups and the no anesthesia control groups.…”

Section: Study Description and Validitymentioning

confidence: 99%

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A meta-analysis of local anesthesia for transrectal ultrasound-guided biopsy of the prostate

Tiong

Liew

Samuel

et al. 2007

Prostate Cancer Prostatic Dis

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This meta-analysis evaluated the efficacy and safety of periprostatic nerve block (PPNB) and intrarectal local anesthestic (IRLA) gel in alleviating pain during prostate biopsy. Electronic databases MEDLINE, Cochrane Central Register of Controlled Trials and EMBASE were searched to identify all randomized controlled trials comparing PPNB with periprostatic placebo injection, no injection or with IRLA. Studies for inclusion were identified and extracted by two authors independently. The main outcome measure was patients' assessment of mean pain scores on a 10-point scale at the end of the biopsy procedure. Secondary outcomes were complications and adverse events. Continuous data from the trials were combined by calculating the weighted mean difference (WMD) with its 95% confidence interval. In total, 25 studies met the inclusion criteria. Twenty studies involving 1685 patients compared PPNB with either no anesthesia or with placebo injection controls, showing a significant reduction in pain score in the anesthetic group (WMD À2.09, 95% CI À2.44 to À1.75, Po0.00001). Five studies with 466 patients compared IRLA and control. Although IRLA was associated with pain reduction, the effect size was not statistically significant (WMD À0.22, 95% CI À0.56 to 0.12). Six studies with 872 patients compared PPNB with IRLA, showing a significant pain reduction in the former group (WMD À1.53, 95% CI À2.67 to À0.39, P ¼ 0.008). No trials reported an increase in complications in the treatment arms. In conclusion, the evidence from randomized controlled trials shows that local anesthetic given as a PPNB, but not as an intrarectal instillation, is effective and safe in alleviating pain from transrectal ultrasound biopsy of the prostate.

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Section: Intrarectal Lignocainementioning

confidence: 97%

Section: Study Description and Validitymentioning

confidence: 99%

Section: Study Description and Validitymentioning

confidence: 99%

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A meta-analysis of local anesthesia for transrectal ultrasound-guided biopsy of the prostate

Tiong

Liew

Samuel

et al. 2007

Prostate Cancer Prostatic Dis

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“…Nevertheless, TRU of the prostate is painful (4), and there were claims from a few patients at our setting that they encountered extreme pain while getting this intrusive technique. Despite the fact that the level of and variables affecting pain amid TRU-guided biopsy were explored in the literature (5)(6)(7), in view of our investigation, there is a dearth of studies that concentrated on pain encountered by the patients undergoing TRU of the prostate.…”

Section: Introductionmentioning

confidence: 99%

Associated Clinical Parameters of Pain in Patients Undergoing Trans Rectal Ultrasonography of the Prostate

2017

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Objectives: The study objective was to determine the way in which patients encounter pain, and to distinguish the clinical parameters impacting pain by transrectal ultrasonography (TRU) of the prostate. Patients and Methods:Medical records for men receiving prostate TRU from November 2015 to April 2016 were acquired from the database. Patients underwent a detail review of medical history as well as physical evaluation. All the relevant variables were associated to visual analog scale (VAS) by using multivariate regression analysis.Results: Independent factors for TRU associated pain were identified using multivariate regression analysis. The analysis demonstrated that sagittal length of the prostate was the continuous variable impacting pain level. Patients who received explanation for the process of the test in detail promptly before the examination and had prior TRU experience were found to be in negative association with the pain score; while, hemorrhoids (external), prior anal surgery, and stool artifact were in positive association with the pain score. Conclusion:Despite the fact that TRU of the prostate is uncomfortable for patients, after identification of pain affecting factors, healthcare providers could help reduce the patients' pain through the procedure, thereby providing better quality exams.

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“…Recommendations provided by contemporary clinical guidelines 1,2 clearly indicate that extended transrectal biopsy protocols with local anesthesia, such as the periprostatic nerve block (PPNB) [3][4][5][6][7] are standard procedures for diagnosing localized prostate cancer today. 1,2,[8][9][10] Although transperineal biopsy has several advantages over transrectal biopsy including a better sampling from the apico-anterior peripheral zone, [11][12][13] a lower risk of infection complications and no risk of rectal bleeding, 11 the lack of an established local anesthetic method prevents it from becoming the standard.…”

Section: Introductionmentioning

confidence: 99%

Simple and effective local anesthesia for transperineal extended prostate biopsy: Application to three‐dimensional 26‐core biopsy

et al. 2009

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Abstract:We developed a local anesthetic procedure for three-dimensional 26-core prostate biopsy (3D26PBx), a combination of transperineal 14-core biopsy (TP14PBx) and transrectal 12-core biopsy (TR12PBx). At first, a periapical triangle, confined by the levator ani, the rhabdosphincter and the external anal sphincter muscle, was made visible by transrectal ultrasound. After administration of 1 mL of 1%-lidocaine into the midline perineal skin 1.5 cm above the anus, we inserted a spinal needle toward the periapical triangle for injection of 1.5-2.0 mL of 1%-lidocaine and performed the TP14PBx. After administration of the periprostatic nerve block with 10 mL of 1%-lidocaine, we performed the TR12PBx. The efficacy of the procedure was evaluated prospectively in 45 consecutive men undergoing the 3D26PBx. The 3D26PBx was completed with just local anesthesia in all patients. The pain levels, assessed by an 11-point visual analog scale, were not different between the TP14PBx and the TR12PBx.

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Bilateral Fine-Needle Administered Local Anaesthetic Nerve Block for Pain Control during TRUS-Guided Multi-Core Prostate Biopsy: A Prospective Randomised Trial

Cited by 74 publications

References 17 publications

A meta-analysis of local anesthesia for transrectal ultrasound-guided biopsy of the prostate

A meta-analysis of local anesthesia for transrectal ultrasound-guided biopsy of the prostate

Associated Clinical Parameters of Pain in Patients Undergoing Trans Rectal Ultrasonography of the Prostate

Simple and effective local anesthesia for transperineal extended prostate biopsy: Application to three‐dimensional 26‐core biopsy

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