Dolor durante biopsia de próstata guiada por ultrasonografía transrectal: Comparación del uso o no de Xilocaína gel como anestésico local

Pérez, G; Montoya, Luis; Deza, Carlos; Godoy, Mariela Pow-Sang; Urrutia, Víctor Destefano

doi:10.1016/s0210-4806(09)74112-9

Cited by 3 publications

(3 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Topical intrarectal application of anesthetic gels (e.g., 2% lidocaine) has been traditionally considered to relieve anal discomfort, but a recent meta-analysis of randomized trials [8] and two subsequent trials [9,10] indicated a lack of an analgesic effect. The present data are in line with these observations.…”

Section: Discussionmentioning

confidence: 99%

“…In the five trials embraced by the recent meta-analysis [8] and two subsequent trials [9,10], pain scores on a 10-point visual analogue scale (VAS) in patients undergoing prostate biopsy with or without intrarectal anesthetic gel averaged between 3 and 5.6 with standard deviations (SDs) between 1.5 and 2.7. In an analysis of variance with 3 treatment groups, assuming a mean VAS score of 5 under the null hypothesis and an SD of 2.5, a total of 126 patients (42 per group) would provide 81% power at the overall 0.05 alpha level to detect a mean difference of 1.5 VAS score points between any two treatments.…”

Section: Methodsmentioning

confidence: 99%

“…However, a recent meta-analysis of 5 other randomized trials comparing intrarectal lidocaine gel with a placebo gel or no treatment [8] and two subsequent trials comparing lidocaine gel with no treatment [9,10] failed to detect a pain-relieving effect of this intervention. Also, a recent randomized trial suggested that pain perception in patients undergoing prostate biopsy might be less profound in the left lateral decubitus (LLD) position than in the lithotomy position [11], whereas another one did not [12].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prostate Biopsy in the Left Lateral Decubitus Position is Less Painful than Prostate Biopsy in the Lithotomy Position: A Randomized Controlled Trial

Lodeta

2012

Korean J Urol

View full text Add to dashboard Cite

PurposeThe primary objective was to assess whether transrectal ultrasound (TRUS)-guided prostate biopsy in the left lateral decubitus (LLD) position differed from the procedure in the lithotomy position regarding patients' pain perception. The secondary objective was to assess the analgesic effect of intrarectal 2% lidocaine gel in this setting.Materials and MethodsThis single-center, open-label trial enrolled 148 men undergoing prostate biopsy. Then men were randomly assigned to group 1 (LLD position, no lidocaine, n=50, "test"), group 2 (lithotomy position+lidocaine, n=50, "positive control"), and group 3 (lithotomy position, no lidocaine, n=48, "negative control"). Twelve-core samples were taken in each biopsy set. Pain was assessed by using a 10-point visual analogue scale (VAS).ResultsAcross the groups, patients were comparable regarding age, prostate-specific antigen levels, prostate volume, digital rectal examination findings, and pathohistological diagnosis. VAS scores were lower in group 1 (median, 2.95) than in group 2 (median, 4.95; p<0.001) or group 3 (median, 4.60; p<0.001). The difference between group 2 and group 3 was insignificant (p=0.268). The adjusted mean differences (with adjustment for the above covariates) were as follows: group 1 vs. group 2, -1.43 (95% confidence interval [CI]: -2.25 to -0.60; p<0.001); group 1 vs. group 3, -1.22 (95% CI: -2.04 to -0.41; p=0.001); group 2 vs. group 3, 0.20 (95% CI, -0.63 to 1.04; p=0.836); and group 1 vs. groups 2 and 3, -1.33 (95% CI, -1.92 to -0.73; p<0.001). The procedure was comparably well tolerated across the groups.ConclusionsPain perception during prostate biopsy was lower in the LLD position than in the lithotomy position. Intrarectal 2% lidocaine gel does not seem to affect pain perception.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prostate Biopsy in the Left Lateral Decubitus Position is Less Painful than Prostate Biopsy in the Lithotomy Position: A Randomized Controlled Trial

Lodeta

2012

Korean J Urol

View full text Add to dashboard Cite

show abstract

The effectivity of periprostatic nerve blockade for the pain control during transrectal ultrasound guided prostate biopsy

Ötünçtemur

Dursun

Beşiroğlu

et al. 2013

Arch Ital Urol Androl

View full text Add to dashboard Cite

Aim: Transrectal ultrasound (TRUS) guided prostete biopsy is accepted as a standard procedure in the diagnosis of prostate cancer. Many different protocoles are applied to reduce the pain during the process. In this study we aimed to the comparison of two procedure with intrarectal lidocaine gel and periprostatice nerve blockade respective- ly in addition to perianal intrarectal lidocaine gel on the pain control in prostate biop- sy by TRUS. Methods: 473 patients who underwent prostate biopsy guided TRUS between 2008-2012 were included in the study. 10-point linear visual analog pain scale(VAS) was used to evaluate the pain during biopsy. The patients were divided into two groups according to anesthesia procedure. In Group 1, there were 159 patients who had perianal-intrarectal lidocaine gel, in Group 2 there were 314 patients who had periprostatic nerve blockade in addition to intrarectal lidocain gel. The pain about probe manipulation was aseesed by VAS-1 and during the biopsy needle entries was evalu- ated by VAS-2. Results were compared with Mann-Whitney U and Pearson chi-square test. Results: Mean VAS-2 scores in Group 1 and Group 2 were 4.54 ± 1.02 and 2.06 ± 0.79 respectively. The pain score was determined significantly lower in the Group 2 (p = 0.001). In both groups there was no significant difference in VAS-1 scores, patient’s age, prostate volume, complication rate and PSA level. Conclusion: The combination of periprostatic nerve blockade and intrarectal lidocain gel provides a more meaningful pain relief compared to group of patients undergoing intrarectal lidocaine gel.

show abstract

The Effects of Combination Perianal-Intrarectal Lidocaine-Prilocaine Cream and Periprostatic Nerve Block for Pain Control during Transrectal Ultrasound Guided Biopsy of the Prostate: A Randomized, Controlled Trial

et al. 2010

View full text Add to dashboard Cite

PurposeProstate biopsy for diagnosing cancer can be painful. The efficacy and safety of combination perianal-intrarectal lidocaine-prilocaine (PILP) cream and periprostatic nerve block were compared with nerve block alone during transrectal ultrasound guided prostate biopsy (TRUS-Bx).Materials and MethodsFrom October 2007 to August 2009, 74 men undergoing a transrectal prostate biopsy were randomized into two groups. In group 1, 36 patients received a combination of PILP cream and a periprostatic nerve block; and in group 2, 38 patients received lubricant jelly and a periprostatic nerve block. Thirty minutes later, the TRUS-Bx was performed. Pain was evaluated by a 10-point visual analogue scale (VAS) after the biopsy.ResultsPatients in group 1 showed a significantly lower VAS score than patients in group 2 (mean score 2.22±0.89 vs. 3.02±1.15, p<0.001). In addition, there was a difference in the number of patients that had a pain score of three or more, 44% in group 1, and 65% in group 2. The overall complication rate was similar in both groups (p=0.45).ConclusionsA combination of PILP cream and periprostatic nerve block reduced pain compared to the periprostatic nerve block alone. This safe, simple technique can be considered prior to TRUS-Bx to reduce patient discomfort.

show abstract

Dolor durante biopsia de próstata guiada por ultrasonografía transrectal: Comparación del uso o no de Xilocaína gel como anestésico local

Abstract: The use of lidocaine gel intrarectal 2% before a prostate biopsy guided by ultrasound did not diminish the sensation of pain from the procedure in our patients, which was increased by the use of sterilized needles.

Cited by 3 publications

References 10 publications

Prostate Biopsy in the Left Lateral Decubitus Position is Less Painful than Prostate Biopsy in the Lithotomy Position: A Randomized Controlled Trial

Prostate Biopsy in the Left Lateral Decubitus Position is Less Painful than Prostate Biopsy in the Lithotomy Position: A Randomized Controlled Trial

The effectivity of periprostatic nerve blockade for the pain control during transrectal ultrasound guided prostate biopsy

The Effects of Combination Perianal-Intrarectal Lidocaine-Prilocaine Cream and Periprostatic Nerve Block for Pain Control during Transrectal Ultrasound Guided Biopsy of the Prostate: A Randomized, Controlled Trial

Contact Info

Product

Resources

About