Comparison Between Lidocaine and Glyceryl Trinitrate Ointment for Perianal-intrarectal Local Anesthesia Before Transrectal Ultrasonography-guided Prostate Biopsy: A Placebo-controlled Trial

Skriapas, Konstantinos; Konstantinidis, Charalampos; Samarinas, Michael; Xanthis, Stylianos; Gekas, Aristomenis

doi:10.1016/j.urology.2010.09.065

Cited by 17 publications

(20 citation statements)

References 19 publications

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“…Regarding minor complications, pooled results showed no significant difference in reported morbidities of fever, hematuria, rectal bleeding, acute urinary retention, dysuria and hematospermia (Table ). The only side‐effect reported associated with local anesthesia was headache in studies using GTN ointment, which improved quickly after the biopsy without delayed discharge …”

Section: Resultsmentioning

confidence: 99%

“…There were 18 studies involving 2076 patients finally eligible for the quantitative analysis, 4,6,10-25 including 16 RCTs 4,6,10,11,13-24 and two retrospective studies. 12,25 The risk of bias was presented with a risk of bias graph ( Fig. 2), randomization sequencing and outcome data reporting were deemed mostly adequate.…”

Section: Discussionmentioning

confidence: 99%

“…Six studies used lidocaine gel 4,10-14 for IRLA, six used lidocaine-prilocaine cream, [15][16][17][18][19][20] three used GTN ointment [21][22][23] and three used a diclofenac suppository. 6,24,25 PPNB was accomplished by a 22-G needle under ultrasound guidance into the neurovascular bundle at the base of the prostate, just lateral to the junction between the prostate and seminal vesicle bilaterally in all, but not specified in three studies. 10,14,18 Core biopsies were obtained by 18-G needles in all studies.…”

Section: Description Of Studiesmentioning

confidence: 99%

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Addition of intrarectal local analgesia to periprostatic nerve block improves pain control for transrectal ultrasonography‐guided prostate biopsy: A systematic review and meta‐analysis

Wang

et al. 2014

Int J of Urology

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Abbreviations & AcronymsObjectives: To evaluate the efficacy and safety of combined intrarectal local analgesia and periprostatic nerve block versus periprostatic nerve block alone for pain control during transrectal ultrasound-guided prostate biopsy. Methods: We comprehensively searched PubMed, Embase and the Cochrane Library trials. Studies comparing the two techniques were identified and pooled for cumulative analysis. The outcome measurements included visual pain scales of three consecutive procedures of transrectal ultrasound-guided prostate biopsy, as well as short-term postoperative complication rates. Results: There were 18 studies that were finally eligible for the quantitative analysis involving 2076 participants. Combined modalities significantly reduced the pain associated with probe manipulation (weighted mean difference −2.06, 95% confidence interval −2.77 to −1.35, P < 0.001), anesthesia infiltration (weighted mean difference −1.45, 95% confidence interval −2.20 to −0.70, P < 0.001) and needle biopsy (weighted mean difference −0.55, 95% confidence interval −0.76 to −0.34, P < 0.001). Subgroup analyses assessing different local analgesics showed that local anesthetics are generally more effective than myorelaxant and non-steroidal anti-inflammatory drugs. Lidocaine-prilocaine cream proved the most effective in pain control regardless of the origin of pain. No significant difference of short-term postoperative complications (fever, dysuria, acute urinary retention, hematuria, hematospermia and rectal bleeding) was found between the two techniques. The only side-effect associated with local analgesics was headache reported in studies using glyceryl trinitrate ointment. Conclusions: Combined modalities show better analgesic efficacy than periprostatic nerve block alone for transrectal ultrasound-guided prostate biopsy without increased morbidities. Among the various local analgesics, lidocaine-prilocaine cream seems to offer the best overall efficacy.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Description Of Studiesmentioning

confidence: 99%

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Addition of intrarectal local analgesia to periprostatic nerve block improves pain control for transrectal ultrasonography‐guided prostate biopsy: A systematic review and meta‐analysis

Wang

et al. 2014

Int J of Urology

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“…In another study by Skriapas et al (8), 223 male candidates of prostate surgery benefited from glyceryltrinitrate ointment for perianal anesthesia in addition to lidocaine through the procedure of trans rectal ultrasonography (TRUS) as well as prostate biopsy.…”

Section: Discussionmentioning

confidence: 99%

Analgesic Effects of Additional Nitroglycerine in Intravenous Regional Lidocaine-Based Anesthesia Through Forearm Surgery

Mahjoubifard¹,

Enayati²,

Babaee³

et al. 2015

Arch Crit Care Med

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Background: Intravenous regional anesthesia (IVRA) (or Bier's block) is the administration of a local anesthetic drug to an organ intravenously, when compressed by tourniquet. Simple use in outpatient and emergency settings, being regional instead of general anesthesia and having reasonable costs make IVRA most acceptable. Objectives: Nitroglycerine, as a safe and available medication, was evaluated by the current study in the search for better analgesia withlower complications that plays the role of a suitable adjuvant in regional anesthesia by lidocaine. Patients and Methods: Through a randomized controlled clinical trial, two types of anesthesia were used regionally for 70 cases of forearm surgery between 2010 and 2011. Elective cases of forearm surgery with American Society of Anesthesiologist (ASA) class I or II were enrolled in the study and were randomly divided to two groups of cases and controls. For the control group, lidocaine was used alone for IVRA while for the intervention group lidocaine as well as 200 µg of nitroglycerin was used through the procedure. Results: On average, sensory block started in 3.48 and 6.5 minutes, for the case and control groups, respectively. The mean motor block time was 4.18 and 6.98 minutes for the cases and controls, respectively. The groups differed in terms of times required for sensory and motor blocks. Recovery time was longer among cases (118.32 ± 7.8 minutes) when compared to the controls. Conclusions: Nitroglycerin at a dose range between 200 and 400 µg, as an adjunct for lidocaine, can evidently improve regional anesthesia, increase block recovery time and postpone the need for postoperative analgesics, especially opioids.

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“…60 This is supported by a study involving 223 men showing that peri-prostatic nerve block in addition to intra-rectal local anesthetic provided superior pain relief compared to peri-prostatic nerve block and intrarectal placebo. 61 Raber et al, noticed a similar benefit to combined peri-prostatic nerve block and intra-rectal local anesthetic over peri-prostatic nerve block alone especially with respect to pain during insertion of the ultrasound report. 62 This lends support to local anesthesia protocols that address both sources of pain during the biopsy procedure.…”

Section: Combination Peri-prostatic Block and Intra-rectal Local Anesmentioning

confidence: 91%

Local Anesthesia for the Prostate Gland

Glass¹,

Punnen²,

Shinohara³

2012

Clinical Use of Local Anesthetics

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Comparison Between Lidocaine and Glyceryl Trinitrate Ointment for Perianal-intrarectal Local Anesthesia Before Transrectal Ultrasonography-guided Prostate Biopsy: A Placebo-controlled Trial

Cited by 17 publications

References 19 publications

Addition of intrarectal local analgesia to periprostatic nerve block improves pain control for transrectal ultrasonography‐guided prostate biopsy: A systematic review and meta‐analysis

Addition of intrarectal local analgesia to periprostatic nerve block improves pain control for transrectal ultrasonography‐guided prostate biopsy: A systematic review and meta‐analysis

Analgesic Effects of Additional Nitroglycerine in Intravenous Regional Lidocaine-Based Anesthesia Through Forearm Surgery

Local Anesthesia for the Prostate Gland

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