Korean J Urol.  2012 Nov;53(11):750-754.

Efficacy of Periprostatic Anesthesia according to Lidocaine Dose during Transrectal Ultrasound-Guided Biopsy of the Prostate

• Kang KS
• Yeo JK
• Park MG
• Cho DY
• Park SH
• Park SS

Abstract

PURPOSE
The aim of this study was to evaluate the efficacy of periprostatic lidocaine injection according to lidocaine dose during transrectal ultrasound-guided prostate biopsy.
MATERIALS AND METHODS
The subjects of this study were 92 patients who had undergone transrectal ultrasound-guided 12-core biopsy of the prostate. The patients were randomly assigned to three groups: group 1 (n=31, no lidocaine injection), group 2 (n=30, periprostatic injection of 10 ml 1% lidocaine), and group 3 (n=31, periprostatic injection of 20 ml 1% lidocaine). The patients were assessed for pain by use of a 10-point visual analogue scale (VAS) and for other complications after the procedure.
RESULTS
The mean VAS scores of groups 1 through 3 were 0.93+/-0.89, 1.32+/-1.37, and 1.13+/-1.10, respectively. There were no statistically significant differences between the three groups. However, the mean VAS score of the biopsy pain was 5.0+/-1.48, 3.93+/-1.94, and 3.60+/-2.15, in the same groups, respectively, with statistically significant differences between group 1 and the other groups. Patients in groups 2 and 3 reported significantly less biopsy pain than did group 1 patients (p=0.004, 0.021), with no statistically significant difference in VAS score between groups 2 and 3 (p=0.533). With respect to post-biopsy complications, there were no significant differences in the incidence of hematuria, hematospermia, rectal bleeding, or infection among the three groups.
CONCLUSIONS
Periprostatic injection of local anesthesia with lidocaine was associated with significantly less pain than in the absence of anesthesia. Furthermore, a 20-ml dose of lidocaine produced no better pain control than did a 10-ml lidocaine dose for prostate biopsy.

Keyword

Anesthesia; Biopsy; Prostate

MeSH Terms

Anesthesia
Anesthesia, Local
Biopsy
Hematuria
Hemorrhage
Hemospermia
Humans
Incidence
Lidocaine
Prostate
Lidocaine

Figure

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  FIG. 1 The dotted line indicates the mean value of the visual analogue scale (VAS) in each group. NB, nerve block.

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  FIG. 2 Transrectal prostate ultrasonographic image (sagittal view). The ultrasonic wheal (collection of lidocaine) is seen as a hypoechoic space (arrow head). The narrow arrow indicates the seminal vesicle.

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