Abstract
Introduction: Currently, the use of local anesthetic at the time of transrectal ultrasound-guided biopsy of the prostate is not universally accepted, as the needle injection itself causes pain. In prior studies, lidocaine was compared to placebo in separate patient groups. We present the first study to evaluate both lidocaine and placebo injected in each patient. Materials and methods: Fifty patients received periprostatic injections of both lidocaine and placebo, randomized to separate sides of the prostate, in a randomized, double-blind, placebo-controlled trial design. Injections were delivered at the angle between the seminal vesicle and prostate on each side. Patients graded pain on a visual analog scale (VAS) (0-10) after injections and after each biopsy. Patients were surveyed to evaluate overall pain and discomfort before discharge. We used Student's t-test to compare the mean VAS scores between lidocaine and placebo. Results: The mean (SD) VAS after biopsy was 1.9 (1.4) on the lidocaine side and 2.3 (1.4) on the placebo side (P = 0.202). Pain after the injection itself was similar to pain after biopsy, with the mean (SD) VAS of 2.4 (1.6) and 2.2 (1.7) after lidocaine and placebo injections, respectively (P = 0.546). None of the differences were statistically significant. Twenty-nine (59.2%) patients reported no pain at the time of discharge. Conclusions: Pain experienced during transrectal biopsy of the prostate is mild and is not significantly lowered with periprostatic nerve block. Pain from injection itself is similar to pain from core biopsies. Pain from transrectal ultrasound-guided biopsy of the prostate is well tolerated with no anesthesia.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 23-27 |
| Number of pages | 5 |
| Journal | International Urology and Nephrology |
| Volume | 42 |
| Issue number | 1 |
| DOIs | |
| State | Published - Mar 1 2010 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Medicine(all)
- Nephrology
- Urology
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Does periprostatic block reduce pain during transrectal prostate biopsy? A randomized, placebo-controlled, double-blinded study. / Ingber, Michael; Ibrahim, Ibrahim; Turzewski, Cynthia; Hollander, Jay B.; Diokno, Ananias C.
In: International Urology and Nephrology, Vol. 42, No. 1, 01.03.2010, p. 23-27.Research output: Contribution to journal › Article
TY - JOUR
T1 - Does periprostatic block reduce pain during transrectal prostate biopsy? A randomized, placebo-controlled, double-blinded study
AU - Ingber, Michael
AU - Ibrahim, Ibrahim
AU - Turzewski, Cynthia
AU - Hollander, Jay B.
AU - Diokno, Ananias C.
PY - 2010/3/1
Y1 - 2010/3/1
N2 - Introduction: Currently, the use of local anesthetic at the time of transrectal ultrasound-guided biopsy of the prostate is not universally accepted, as the needle injection itself causes pain. In prior studies, lidocaine was compared to placebo in separate patient groups. We present the first study to evaluate both lidocaine and placebo injected in each patient. Materials and methods: Fifty patients received periprostatic injections of both lidocaine and placebo, randomized to separate sides of the prostate, in a randomized, double-blind, placebo-controlled trial design. Injections were delivered at the angle between the seminal vesicle and prostate on each side. Patients graded pain on a visual analog scale (VAS) (0-10) after injections and after each biopsy. Patients were surveyed to evaluate overall pain and discomfort before discharge. We used Student's t-test to compare the mean VAS scores between lidocaine and placebo. Results: The mean (SD) VAS after biopsy was 1.9 (1.4) on the lidocaine side and 2.3 (1.4) on the placebo side (P = 0.202). Pain after the injection itself was similar to pain after biopsy, with the mean (SD) VAS of 2.4 (1.6) and 2.2 (1.7) after lidocaine and placebo injections, respectively (P = 0.546). None of the differences were statistically significant. Twenty-nine (59.2%) patients reported no pain at the time of discharge. Conclusions: Pain experienced during transrectal biopsy of the prostate is mild and is not significantly lowered with periprostatic nerve block. Pain from injection itself is similar to pain from core biopsies. Pain from transrectal ultrasound-guided biopsy of the prostate is well tolerated with no anesthesia.
AB - Introduction: Currently, the use of local anesthetic at the time of transrectal ultrasound-guided biopsy of the prostate is not universally accepted, as the needle injection itself causes pain. In prior studies, lidocaine was compared to placebo in separate patient groups. We present the first study to evaluate both lidocaine and placebo injected in each patient. Materials and methods: Fifty patients received periprostatic injections of both lidocaine and placebo, randomized to separate sides of the prostate, in a randomized, double-blind, placebo-controlled trial design. Injections were delivered at the angle between the seminal vesicle and prostate on each side. Patients graded pain on a visual analog scale (VAS) (0-10) after injections and after each biopsy. Patients were surveyed to evaluate overall pain and discomfort before discharge. We used Student's t-test to compare the mean VAS scores between lidocaine and placebo. Results: The mean (SD) VAS after biopsy was 1.9 (1.4) on the lidocaine side and 2.3 (1.4) on the placebo side (P = 0.202). Pain after the injection itself was similar to pain after biopsy, with the mean (SD) VAS of 2.4 (1.6) and 2.2 (1.7) after lidocaine and placebo injections, respectively (P = 0.546). None of the differences were statistically significant. Twenty-nine (59.2%) patients reported no pain at the time of discharge. Conclusions: Pain experienced during transrectal biopsy of the prostate is mild and is not significantly lowered with periprostatic nerve block. Pain from injection itself is similar to pain from core biopsies. Pain from transrectal ultrasound-guided biopsy of the prostate is well tolerated with no anesthesia.
UR - http://www.scopus.com/inward/record.url?scp=77950917837&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77950917837&partnerID=8YFLogxK
U2 - 10.1007/s11255-009-9621-2
DO - 10.1007/s11255-009-9621-2
M3 - Article
C2 - 19669586
AN - SCOPUS:77950917837
VL - 42
SP - 23
EP - 27
JO - International Urology and Nephrology
JF - International Urology and Nephrology
SN - 0301-1623
IS - 1
ER -