Abstract

CERVERA DEVAL, J. et al. Utility of local anesthesia of the periprostatic plexus in the control of the pain in the ultrasound-guided prostate biopsy. Actas Urol Esp [online]. 2005, vol.29, n.10, pp.943-947. ISSN 0210-4806.

Objetive: Periprostatic plexus anesthesia (PPA) is not current practice during prostate ultrasound-guided biopsy (PB). Many patients must undergo a second or more PB if a prostate carcinoma is suspected. Due to pain, many patients reject the procedure, or it has to be performed with general anesthesia. Our objective was to evaluate the utility of PPA to eliminate the pain caused by PB, as well as the acceptance of the procedure under these conditions. Patients and Methods: Between october 2002 and june 2003 we designed a randomized prospective study with 275 patients that were seen in 2 different hospitals and required PB. In the 1st group we included 101 males who underwent PB without PA. In the other group, 174 male patients submitted PB after PPA were included. 10 cc lidocaine, 2% diluted 50% was injected with a 22g needle. At the end of the procedure, patients were asked to fill in a questionnaire about their satisfaction and degree of pain felt. Results: In the second group of patients we obtained significantly inferior values (p<0.005, IC 95%) in the quantitative evaluation of pain compared with the first group (1.24±0.4 vs. 2.5 ±1.1). Ask per the possibility of repeating PB if it were necessary, none of the patients in the 2nd group would object, whereas 10% in the 1st group would not have the biopsy repeated or would only accept it if it was done with general anesthesia. No complications due to PPA were found. Conclusion: PPA is a safe procedure that significantly reduces pain during PB, improving its acquiescence among patients.

Keywords : Pain; Local anesthesia; Ultrasound; Transrectal; Prostate biopsy.

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