Local Anesthesia During 10 Core Biopsy of the Prostate: Comparison of 2 Methods

Mutaguchi, Kazuaki; Shinohara, Katsuto; Matsubara, Akio; Yanagimoto, Hiroaki; Mita, Koji; Usui, Tsuguru

doi:10.1097/01.ju.0000152119.28959.3a

Cited by 49 publications

(37 citation statements)

References 17 publications

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“…69 The reported complication rate associated with periprostatic nerve block ranges from 2-4%. 17,20,69,70 No significant complication differences were found with intraprostatic analgesia injection 64,67,68 or topical agents. 22,63,71 Of note, reported morbidity is confounded by the fact that many of the complications (i.e.…”

Section: Complicationsmentioning

confidence: 96%

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Local Anesthesia for the Prostate Gland

Glass¹,

Punnen²,

Shinohara³

2012

Clinical Use of Local Anesthetics

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Section: Complicationsmentioning

confidence: 96%

“…64 Intra-prostatic injection provides local anesthetic to sensory fibers within the parenchyma of the prostate, which have a high sensitivity to pain. Secondly, peri-prostatic nerve block does not anesthetize the anterior part of the gland, while intra-prostatic injection does.…”

Section: Intra-prostatic Injection Of Local Anestheticmentioning

confidence: 99%

Local Anesthesia for the Prostate Gland

Glass¹,

Punnen²,

Shinohara³

2012

Clinical Use of Local Anesthetics

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“…15 Although Mutaguchi and colleagues asserted that intraprostatic infiltration was superior to periprostatic infiltration, 16 we routinely perform both periprostatic and intraprostatic infiltration as the latter is not associated with additional pain and adds little to the overall duration of the procedure. As long as one steers clear of the urethra, hematuria is uncommon.…”

Section: Discussionmentioning

confidence: 99%

A prospective study on pain score with transperineal prostatic gold seed fiducial implantation under local anesthetic alone

Tang

Sethukavalan

Cheung

et al. 2012

CUAJ

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Background: The purpose of this study was to monitor patient pain score with transperineal prostatic gold seed implantation in the absence of conscious sedation. Methods: All patients who were scheduled for image-guided external beam radiation (IGRT) and referred for gold seed fiducials were eligible to participate. Gold seed implants were performed by two radiation oncologists between December 2007 and April 2008. Patients received only local and deep anesthetic. No patients had prophylactic IV cannulation for the procedure. Three gold seeds were inserted transperineally into the prostate. A visual analogue scale from 0 to 10 was used to assess the pain at baseline, local and deep anesthetic infiltration, with each seed drop, and after the completion of the procedure. Results: A total of 30 patients were accrued to this study. The highest recorded increase in pain score was at the time point of deep local anesthesia, at which the mean pain score was 3.8. The mean pain scores at each seed drop were 0.8 (standard deviation [SD]=1.24), 1 (SD=1.26), and 0.5 (SD=0.90), respectively. All gold seed insertion procedures were well-tolerated, with no patients having significant pain post-procedure, and no significant procedural complications. There were only slight increases in dysuria, urinary frequency, constipation, urinary retention and flatulence in 7 patients -none of which required intervention. Interpretation: Transperineal ultrasound-guided gold seed implantation without conscious sedation is well-tolerated and associated with a low complication rate. It is a convenient outpatient procedure obviating the need for resource intensive postoperative monitoring. IntroductionModern prostate radiotherapy is trending towards higher biological doses. [1][2][3][4] There is a greater need for better accuracy in radiation treatment delivery if toxicities are not to increase. For patients undergoing image-guided external beam prostate radiotherapy (IGRT), gold seed fiducial implantation in the prostate is common. These gold seeds are usually small (typically about 1 × 3 mm) and are chemically inert.Being radio-opaque, gold seeds are easily identified on kilovoltage and megavoltage x-rays. This allows for daily online imaging and position adjustment before treatment. Daily online imaging based on fiducials reduces systematic and random errors, and is superior to offline imaging based on bony anatomy.5-9 As a result, studies have established that with the use of fiducials, clinical target volume and planning target volume margins can be reduced, allowing for more sparing of normal tissues without geographical miss. 9,10The Odette Cancer Centre (OCC) has been using fiducials for prostate radiotherapy since 2001. Initially, conscious sedation with intravenous midazolam and fentanyl was administered to all patients prior to fiducial implantation. This required the patient to remain at the OCC for about 1 hour after the procedure for monitoring in the recovery room before discharge. Furthermore, patients were not permitted...

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“…This finding is congruent with prior studies that have also suggested that the apical biopsy is associated with significant pain. 7,14,[17][18][19] The discomfort of apical biopsies is related to the anatomic relation between the prostatic apex and innervation of the rectum below the dentate line. We have used the ''rectal sensation test,'' 18 but have not found it helpful when patients are in the prone jackknife position.…”

Section: Discussionmentioning

confidence: 99%

Preventing pain during office biopsy of the prostate

Ashley

Inman

Routh

et al. 2007

Cancer

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Leaf protein concentrates (LPC) can be used as a valuable co‐product to cellulosic biofuel production and can also mitigate the food versus fuel controversy. Two major approaches have been considered for LPC production: a well‐characterized mechanical pressing method and a less studied method involving aqueous extraction with recovery using ultrafiltration. Experimental results with switchgrass extracts show low protein recovery after filtration, particularly if protein is recovered after cellulose hydrolysis. Economic modeling suggests that aqueous extraction costs less than mechanical pressing, but due to lower protein yields and lower quality, overall profit is higher for mechanical pressing versus aqueous extraction ($26/Mg feedstock vs. $14/Mg). If modest improvements can be made in extraction yields, filtration recovery, and protein quality, then the profitability of the aqueous extraction approach can be increased to $37/Mg feedstock. This study suggests that aqueous extraction is a viable alternative for LPC co‐production in a biorefinery if key improvements can be made in the process. Biotechnol. Bioeng. 2011; 108:530–537. © 2010 Wiley Periodicals, Inc.

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Local Anesthesia During 10 Core Biopsy of the Prostate: Comparison of 2 Methods

Cited by 49 publications

References 17 publications

Local Anesthesia for the Prostate Gland

Local Anesthesia for the Prostate Gland

A prospective study on pain score with transperineal prostatic gold seed fiducial implantation under local anesthetic alone

Preventing pain during office biopsy of the prostate

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