Comparison of two different anesthetic methods on pain perception in prostate biopsy

DOI: 10.4328/JCAM.6028 Received: 23.09.2018 Accepted: 25.10.2018 Published Online: 30.10.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 121-4 Corresponding Author: Engin Kolukcu, Department of Urology, Tokat State Hospital, Tokat, Turkey. GSM: +905354002385 F.: +90 3562120258 E-Mail: drenginkolukcu@gmail.com ORCID ID: 0000-0003-3387-4428 Abstract Aim: In this study, we aimed to compare the efficiency of two different local anesthetic techniques in transrectal ultrasound (TRUS) guided prostate biopsy. Material and Method: The medical records of 798 patients who underwent 12 core transrectal ultrasound guided prostate biopsy were evaluated retrospectively. The patients were divided into 2 groups to receive two different kinds of anesthesia during the procedure as follows: Group 1, rectal application of 2% lidocaine gel and Group 2 periprostatic nerve block. The perception of pain during the insertion of the probe and during the biopsy procedure was scored for each group separately by using a visual analog scale (VAS). Results: The mean age, mean total PSA level and mean prostate volume of the patients in Group 1 were 67.67 ± 8.91 years, 12.57 ± 17.67 ng/ml and 51.41 ± 22.62 ml respectively. The mean age, mean total PSA level and mean prostate volume of the patients in Group 2 were 64.64 ± 7.63 years, 13 ± 18.02 ng/ml and 53.44 ± 44.01 ml respectively. The mean VAS scores of Group 1 and Group 2 during probe insertion were 4,87 ± 1,14 and 5,19 ± 1,16 respectively (p<0.001). The mean VAS scores during biopsy were 3,56 ± 1,43 for Group 1 and 2,5 ± 0,91 for Group 2. The difference between these scores was statistically significant (p<0.001). Discussion: Using of lidocaine gel for analgesia in TRUS-guided prostate biopsy significantly decreases the perception of pain experienced during the probe insertion procedure. On the other hand, PPNB is more effective than the using of lidocaine gel in pain control when the level of pain experienced during the biopsy is examined. Analgesia is substantially ensured by using PPNB, but analgesia combined with topical anesthetic agents could provide a more comfortable biopsy procedure.