Unilateral pudendal nerve blockade for relief of all pain during transrectal ultrasound-guided biopsy of the prostate: A randomized, double-blind, placebo-controlled study

Adsan, Öztuğ; Inal, Gurdal; Ozdogan, Levent; Kaygısız, Onur; Uğurlu, Özgür; Çetinkaya, Mesut

doi:10.1016/j.urology.2004.04.033

Cited by 27 publications

(24 citation statements)

References 18 publications

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“…As a result, the level of pain during DRE appears to be effective in determining the patients in need of additional anesthesia for probe insertion pain, rather than determining patients in need of local anesthesia. Applying pudendal nerve blockade, 40% DMSO with lidocaine intrarectal gel or topical anesthesia with prilocaine-lidocaine cream to prevent probe insertion pain in such patients seems to be a good approach (10)(11)(12).…”

Section: Commentsmentioning

confidence: 99%

Can pain during digital rectal examination help us to decide the necessity and the method of anesthesia for transrectal ultrasound guided prostate needle biopsy?

et al. 2007

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Objective: Transrectal ultrasound (TRUS) guided prostate biopsy is well tolerated by patients but the lack of an effective marker to predict pain prevents us from determining pre-procedurally which patient group needs local anesthesia for biopsy and probe pain. Thus in this study, we investigated predictor factors for prostate biopsy and probe insertion pain. Materials and Methods: 71 patients who were undergoing prostate biopsy without anesthesia were included in the study retrospectively. Pain had been assessed with visual analogue scale (VAS 0-10). Digital rectal examination (DRE) pain was analyzed for biopsy and probe insertion pain. Results: DRE pain was related to both probe pain and biopsy pain. Conclusion: Although level of pain during DRE determines patients in need of local anesthesia, since the number of patients with moderate-severe pain is rather big, it seems efficient in determining the patients in need of additional anesthesia due to probe pain.

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Section: Commentsmentioning

confidence: 99%

Can pain during digital rectal examination help us to decide the necessity and the method of anesthesia for transrectal ultrasound guided prostate needle biopsy?

et al. 2007

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“…Naja et al 2004 studied 90 patients undergoing hemorrhoidectomy and determined that patients who received PNB had significantly superior pain relief, faster return to daily activities, reduced need for analgesics, and higher satisfaction than patients who received general anesthesia alone or general anesthesia and placebo nerve block [4]. Similarly, Adsan et al 2004 studied 51 patients undergoing TRUS-guided prostate biopsy and showed that patients who received unilateral PNB reported significantly less pain during prostate biopsy…”

Section: Discussionmentioning

confidence: 99%

“…Nothing to declare and probe manipulation [5]. In our case series, patients received general anesthesia for urethroplasty, with PNB performed prior to the procedure and in one patient at the end of the operation to reduce postoperative pain.…”

Section: Conflict Of Interestmentioning

confidence: 99%

“…This complexity often leads to the underuse of the PNB in men. While the merits of PNB in anorectal procedures such as hemorrhoidectomy [2][3][4] and transrectal ultrasound (TRUS)-guided prostate biopsy [5] are well studied, its utility in urologic procedures has not been as well described. We report a series of three male patients who received ultrasound and nerve stimulator guided PNB for postoperative analgesia following urethroplasty.…”

Section: Introductionmentioning

confidence: 99%

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Pudendal nerve blocks in men undergoing urethroplasty: a case series

2017

Rom J Anaesth Intensive Care

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The pudendal nerve block (PNB) is widely used for regional anesthesia during obstetric and anorectal procedures, but its role in urologic procedures has not been thoroughly studied. While transvaginal PNB is relatively straightforward, PNB in male patients often requires imaging guidance due to difficulty appreciating anatomic landmarks. We review the PNB and relevant sonoanatomy, and describe its analgesic efficacy in three male patients undergoing urethroplasty for urethral stricture. In this procedure, the patient was placed in lithotomy position, the ischial tuberosity was palpated, and the sacrotuberous ligament and pudendal artery were identified using ultrasound. Ropivacaine was injected medial to the pudendal artery and disappearance of muscle twitch was demonstrated. Two patients reported well-controlled pain at 24 hours postoperatively. One reported perineal pain requiring additional analgesia. All patients were discharged on postoperative day 1 without complications. Ultrasound-guided PNB provides safe and reasonably effective pain control to male patients undergoing urologic procedures.

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“…29 Alternatively, several studies did demonstrate success with pelvic plexus block under skilled guidance and doppler ultrasound. 30,31 Caudal block has also been utilized as an approach to anesthetize the prostate as it provides perianal analgesia and anal sphincter relaxation. However, mixed results have been published regarding its efficacy.…”

Section: Evolution Of Prostatic Analgesiamentioning

confidence: 99%