Local Anesthesia Before Transrectal Ultrasound Guided Prostate Biopsy: Comparison of 2 Methods in a Prospective, Randomized Clinical Trial

Mallick, S.; Humbert, Mathieu; Braud, Frédéric; Fofana, M.; Blanchet, Pascal

doi:10.1097/01.ju.0000108125.96072.ff

Cited by 43 publications

(34 citation statements)

References 18 publications

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“…There were no severe complications that required hospitalization in any of the patients. Similarly, in several studies, it has been shown that the use of periprostatic blockage with an intrarectal gel is better than placebo (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Entonox, which is a gas anaesthetic material (50% nO and 50% O 2 mixture), is widely used in the UK during delivery, in minor procedures treating trauma, and in emergencies, because it provides short-term anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

Three different techniques for administering analgesia during transrectal ultrasound-guided prostate biopsy: a comparative study

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Three different techniques for administering analgesia during transrectal ultrasound-guided prostate biopsy: a comparative study

et al. 2012

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“…Inal [40] No adverse events from LA injection. No significant difference in hematuria and hematochezia between LA and CT. Mallick [43] No difference (LA vs. CT) in hematuria (2% vs. 2%), hematospermia (1% vs. 1%). Vanni [55] No difference in hematuria and rectal bleeding between LA & CT. Nambirajan [44] No significant difference in hematuria (8.4% vs. 10.4%), rectal bleeding (8.4% vs. 6.3%), hematospermia (18.8% vs. 23%) and infection (8.3% vs. 10.4%) between groups (LA vs. CT).…”

Section: Intrarectal Lignocainementioning

confidence: 99%

“…Patients with a final pathological diagnosis of cancer may suffer less pain than those with benign pathological results. 43 Pre-biopsy anxiety is also thought to be an important factor for increased pain sensation. 42 Further research into these factors will enable urologists to tailor their pain relief regime for each individual patient undergoing prostate biopsy.…”

Section: Intrarectal Lignocainementioning

confidence: 99%

“…[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%

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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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“…6 The use of lidocaine topical anesthetic as a single agent for ocular procedures has been reviewed in several studies. [7][8][9][10][11][12][13] Although considered an off-label use of lidocaine 2% (urogenital) jelly, many of these ophthalmic studies had positive findings.…”

mentioning

confidence: 99%

A novel lidocaine hydrochloride ophthalmic gel for topical ocular anesthesia

Busbee¹

2010

LRA

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Topical anesthetics play an important role in the practice of ophthalmology, both for procedures in the office and in the operating room. The need for safe, long-acting topical ocular anesthetic agents is ongoing, and has been highlighted by the increase of intravitreal administration of pharmacologic agents. Current practices for ocular anesthesia include subconjunctival injection of 2% aqueous lidocaine, topical 2% lidocaine drops and topical 0.5% tetracaine. Tetracaine is not yet FDA approved, and is associated with corneal epithelial toxicity and delayed epithelial healing after multiple administrations. Lidocaine jelly (2%) preparations have been reported to be beneficial in several systemic procedures, including those of the upper airway, dental, urogenital, and gastrointestinal. It has been theorized, and recent studies support the idea, that gel formulations of lidocaine may enhance anesthetic effect, and therefore be superior to anesthetic solutions for topical cataract surgery. The viscous nature of gel formulations is thought to lengthen contact time, resulting in better anesthesia at lower drug concentrations. Furthermore, several studies suggest that lidocaine is bactericidal and bacteriostatic, and may have a supplementary role in preventing and treating surgical site infections. Akten™, lidocaine 3.5% gel (Akorn, Buffalo Grove, IIlinois) was FDA approved for all ophthalmic procedures in October 2008. This gel is a preservative-free, lidocaine-based anesthetic gel consisting of 35 mg/mL of lidocaine hydrochloride. We describe the properties, including chemical structure, indications, evidence of support, use, adverse effects, and precautions, which we believe enable Akten to provide superior anesthesia, while minimizing side effects.

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Local Anesthesia Before Transrectal Ultrasound Guided Prostate Biopsy: Comparison of 2 Methods in a Prospective, Randomized Clinical Trial

Cited by 43 publications

References 18 publications

Three different techniques for administering analgesia during transrectal ultrasound-guided prostate biopsy: a comparative study

Three different techniques for administering analgesia during transrectal ultrasound-guided prostate biopsy: a comparative study

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

A novel lidocaine hydrochloride ophthalmic gel for topical ocular anesthesia

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