Randomized prospective study of periprostatic local anesthesia during transrectal ultrasound-guided prostate biopsy

Kaver, Issac; Mabjeesh, Nicola J.; Matzkin, Haim

doi:10.1016/s0090-4295(01)01538-2

Cited by 75 publications

(59 citation statements)

References 12 publications

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“…Cross-sectional studies on morbidity of prostate biopsies by Djavan et al 60 and Rodriguez et al 59 have concurred that younger patients had a higher discomfort rate. Studies included within this meta-analysis 27,37,38 confirm this. Despite the report by Naughton et al 61 that a 12-core biopsy procedure has no significant difference in pain compared to a 6-core procedure, others have shown that the pain level does increase significantly with increasing number of biopsies.…”

Section: Intrarectal Lignocainesupporting

confidence: 67%

“…15,24 Eight studies were excluded because complete data on the mean or standard deviation of the pain scores of the patients was not provided or obtainable. 16,[25][26][27][28][29][30][31] Two studies were excluded as they were duplicates. 32,33 A total of 25 trials were eventually evaluated.…”

Section: Study Selectionmentioning

confidence: 99%

“…Despite the report by Naughton et al 61 that a 12-core biopsy procedure has no significant difference in pain compared to a 6-core procedure, others have shown that the pain level does increase significantly with increasing number of biopsies. 27,51 Apical biopsies were also thought to be more painful than biopsies of the prostate base. 27,51 In the study by Kaver et al, 27 patients with a prostate volume Figure 8 Forest plot comparing PPNB with intrarectal local anesthetic gel.…”

Section: Intrarectal Lignocainementioning

confidence: 99%

“…27,51 Apical biopsies were also thought to be more painful than biopsies of the prostate base. 27,51 In the study by Kaver et al, 27 patients with a prostate volume Figure 8 Forest plot comparing PPNB with intrarectal local anesthetic gel.…”

Section: Intrarectal Lignocainementioning

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 Lignocainesupporting

confidence: 67%

Section: Study Selectionmentioning

confidence: 99%

Section: Intrarectal Lignocainementioning

confidence: 99%

Section: Intrarectal Lignocainementioning

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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“…Before we began performing periprostatic anesthesia, we believed the apex was more sensitive to pain than the rest of the gland as reported by Kaver. 10 We now believe the increased pain experienced with apical biopsy is due to the inferior rectal nerve pain fibers below the dentate line. If the patient can feel the needle lightly touching rectal mucosa overlying the apex, we move slightly cephalad prior to passing through the rectal wall.…”

Section: Discussionmentioning

confidence: 94%

Periprostatic local anesthesia eliminates pain of office-based transrectal prostate biopsy

Jones

Ulchaker

Nelson

et al. 2003

Prostate Cancer Prostatic Dis

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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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Randomized prospective study of periprostatic local anesthesia during transrectal ultrasound-guided prostate biopsy

Cited by 75 publications

References 12 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

Periprostatic local anesthesia eliminates pain of office-based transrectal prostate biopsy

Preventing pain during office biopsy of the prostate

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