Biopsia prostática ecodirigida: comparación de dos métodos anestésicos

Redondo, C. Conde; Fernández, D. Alonso; Samaniego, A. Robles; González, N. Del Valle; Royo, F. Castroviejo; Marcos, Christine; Toves, A. Rodríguez; Oceja, José María Martínez-Sagarra

doi:10.4321/s0210-48062006000200004

Cited by 2 publications

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“…Use of intrarectal enemas with 1% lidocaine has been suggested as equally effective as periprostatic injection of 1% lidocaine for pain control. Other studies promote the use of topical anesthesia (EMLA cream) over placebo and periprostatic nerve blockage with lidocaine (15) Although numerous techniques have been used to reduce or abolish pain in transrectal biopsy, none has been definitively proven as superior to periprostatic nerve blockage and local anesthetic (16). …”

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Periprostatic Nerve Block and Diclofenac Patch in Transrectal Ultrasound-Guided Prostatic Needle Biopsy

et al. 2012

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BackgroundThe aim of the present study was to compare two analgesic techniques for transrectal ultrasound (TRUS)-guided biopsy: diclofenac patch versus periprostatic nerve block with 1% lidocaine.ObjectivesTo study the efficacy of and compare diclofenac patch and periprostatic nerve block as analgesia in TRUS-guided prostate needle biopsy.Patients and MethodsIn total, 60 patients were prospectively randomized into three groups: those in whom a diclofenac patch was used (n = 20), those in whom periprostatic nerve block was used (n = 20), and a control group (n = 20). Prostate biopsy was performed after administration of analgesia according to group.ResultsThe three groups were similar in terms of age, prostate volume, and PSA (prostate-specific antigen) levels. Pain scores were significantly lower in the nerve block group (P = 0.000) at the time of biopsy until 2 h postprocedure, but not at 4 h postprocedure (P = 0.068). No significant difference in pain score was observed in the diclofenac patch group at the time of biopsy (P = 0.106) as compared to the control group, but the diclofenac patch provided adequate pain relief 1 h (P = 0.000), 2 h (0.000), and 4 h (0.002) postprocedure. No significant difference was observed in pain score between the nerve block (P = 0.520) and control groups (0.057) at probe insertion. The pain score at 4 h was significantly lower in the patch group compared to the nerve block and control groups.ConclusionsPeriprostatic nerve block provides superior analgesia for TRUS-guided biopsy. Diclofenac patch is useful as an adjunct.

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Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Periprostatic Nerve Block and Diclofenac Patch in Transrectal Ultrasound-Guided Prostatic Needle Biopsy

et al. 2012

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Comparative Evaluation of Periprostatic Nerve Block with and without Intraprostatic Nerve Block in Transrectal Ultrasound-Guided Prostatic Needle Biopsy

et al. 2012

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PurposeControversy exists over the pain during prostate biopsy. Periprostatic nerve block is a commonly used anaesthetic technique during transrectal ultrasound (TRUS)-guided prostate biopsy. The recent trend toward increasing the number of cores has become popular. This practice further increases the need for a proper anaesthetic application. We compared the efficacy of periprostatic nerve block with or without intraprostatic nerve block.Materials and MethodsWe conducted a prospective double-blinded placebo-controlled study at our institute with 142 consecutive patients. Patients were randomly assigned into 3 groups. Group 1 received periprostatic nerve block with intraprostatic nerve block with 1% lignocaine. Group 2 patients were administered periprostatic nerve block only with 1% lignocaine. Group 3 received no anaesthesia. Patients were asked to grade their level of pain by using an 11-point linear analogue scale at the time of ultrasound probe insertion, at the time of anaesthesia, during biopsy, and 30 minutes after biopsy.ResultsThe study groups were comparable in demographic profile, prostate-specific antigen (PSA) level, and prostate size. The mean pain scores at the time of biopsy in groups 1, 2, and 3 were 2.70, 3.39, and 4.16, respectively. Group 1 recorded the minimum mean pain score of 2.70 during prostate biopsy, which was significantly lower than the scores of groups 2 and 3 (p<0.001). There were no significant differences in pain scores among the 3 groups during probe insertion, during anaesthesia, or at 30 minutes after biopsy (p>0.05).ConclusionsPeriprostatic nerve block with intraprostatic nerve block provides better pain control than does periprostatic nerve block alone in TRUS-guided prostate biopsy.

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Biopsia prostática ecodirigida: comparación de dos métodos anestésicos

Cited by 2 publications

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Comparative Evaluation of Periprostatic Nerve Block and Diclofenac Patch in Transrectal Ultrasound-Guided Prostatic Needle Biopsy

Comparative Evaluation of Periprostatic Nerve Block and Diclofenac Patch in Transrectal Ultrasound-Guided Prostatic Needle Biopsy

Comparative Evaluation of Periprostatic Nerve Block with and without Intraprostatic Nerve Block in Transrectal Ultrasound-Guided Prostatic Needle Biopsy

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