Comparison of two analgesia applied to periprostatic nerve blockage during transrectal ultrasound guided prostate biopsy
Northern Clinics of Istanbul, cilt.12, sa.4, ss.419-424, 2025 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 12 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.14744/nci.2024.79577
- Dergi Adı: Northern Clinics of Istanbul
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Central & Eastern European Academic Source (CEEAS), Directory of Open Access Journals, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.419-424
- Anahtar Kelimeler: Analgesia, anesthesia, biopsy, prostate
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
OBJECTIVE: A combination of local anesthetic treatments provides better pain alleviation than periprostatic nerve block (PPNB) alone during a prostate biopsy procedure. The primary objective of this study was to compare Visual Analog Scale (VAS) pain levels during transrectal ultrasound (TRUS)-guided prostate biopsy whilst the use of prilocaine-lidocaine cream, diclofenac suppository, or PPNB only in a prospective, randomized study. METHODS: This study included 162 patients who had TRUS-guided prostate biopsies performed at the Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Center within a 6 month period, from April to October 2017. Three groups of patients were randomly assigned: group 1 underwent PPNB plus prilocaine-lidocaine cream, group 2 received diclofenac suppository along with PPNB, and group 3 underwent PPNB alone. The VAS was used to measure the degree of pain: VAS 1 was used to record the pain at the time the ultrasound probe was inserted, VAS 2 was used to document the pain during PPNB, and VAS 3 was used to record the pain during needle biopsy. Following the biopsy, any complications or negative consequences were recorded. RESULTS: Mean age or serum prostate specific antigen (PSA) levels were similar between the three groups. The VAS 1, VAS 2, and VAS 3 pain scores showed statistically significant difference among the three groups (p=0.001). Between groups 1 and 2, there was a statistically significant difference in VAS 1 pain scores (p=0.01). There was no statistically difference in VAS 2 and VAS 3 pain scores between the groups 1 and 2 (p=0.08 and p=0.23, respectively). Patients between the groups 3 and other groups had significantly difference in VAS pain scores (p<0.05). CONCLUSION: In this study, we highlight that when applied as an adjuvant to PPNB, either 5% prilocaine-lidocaine cream or a 100 mg diclofenac suppository reduced pain levels relative to PPNB alone. When compared to a 100 mg diclofenac suppository, prilocaine-lidocaine cream significantly reduces pain during the insertion and manipulation of the ultrasound probe.