Comparison of local anesthesia techniques during transrectal ultrasound-guided biopsies

Stirling, Brian; Shockley, Kenneth F.; Carothers, George G.; Maatman, Thomas J.

doi:10.1016/s0090-4295(02)01671-0

Cited by 80 publications

(62 citation statements)

References 12 publications

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“…7,11,12 The most common methods for alleviating discomfort during TRUS-guided biopsy are intrarectal gel or periprostatic injection. 13,14 Periprostatic nerve blocks have been reported to be effective for the reduction in discomfort, but may have limited ability to reduce Prostate biopsy under monitored anesthesia SG Kang et al 725 pain. 15,16 In addition, nerve blocks do not reduce pain during the insertion of ultrasound probes, and are even associated with increases in pain during repeated needle punctures.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and cost analysis of transrectal ultrasound-guided prostate biopsy under monitored anesthesia

Kang¹,

Tae²,

Min³

et al. 2011

Asian J Androl

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Section: Resultsmentioning

confidence: 99%

Efficacy and cost analysis of transrectal ultrasound-guided prostate biopsy under monitored anesthesia

Kang¹,

Tae²,

Min³

et al. 2011

Asian J Androl

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“…Randomization methods were judged to be adequate in 10 studies. [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.…”

Section: Study Description and Validitymentioning

confidence: 99%

“…In three of the studies, all three arms (control, IRLA gel, PPNB) were included for comparisons. 34,53,54 Appropriate data from each publication was extracted for the meta-analysis to facilitate comparisons between the arms. Lastly, the patients in the studies also varied according to the number of biopsies taken.…”

Section: Study Description and Validitymentioning

confidence: 99%

“…Despite this, there are some studies to suggest that it may reduce the pain from probe insertion, due to the presence of pain sensory innervations below the dentate line. 53 In a threeway comparison, Stirling et al 53 found out that although patients who received local anethesia of any type had significantly lower pain scores than the control group; patients who received IRLA had the lowest scores for probe insertion, but not for biopsy. Some investigators have argued that not all patients require local anesthesia and local anesthetic techniques should be targeted at patients who would most benefit from them.…”

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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“…15 A recent study randomized 150 men to no anesthesia, 10 ml of 2% lidocaine gel intra-rectally or a peri-prostatic injection of 5 ml of 1% lidocaine solution prior to ultrasound guided biopsy of the prostate. 16 They found that both groups who received anesthesia reported less pain then the group that did not receive anesthesia. The group that received intra-rectal lidocaine gel reported the least pain with ultrasound probe insertion, while the group that received peri-prostatic lidocaine injection reported the least pain with the actual biopsy.…”

Section: Sources Of Painmentioning

confidence: 99%

Local Anesthesia for the Prostate Gland

Glass¹,

Punnen²,

Shinohara³

2012

Clinical Use of Local Anesthetics

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Comparison of local anesthesia techniques during transrectal ultrasound-guided biopsies

Cited by 80 publications

References 12 publications

Efficacy and cost analysis of transrectal ultrasound-guided prostate biopsy under monitored anesthesia

Efficacy and cost analysis of transrectal ultrasound-guided prostate biopsy under monitored anesthesia

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

Local Anesthesia for the Prostate Gland

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