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BMMR. 2009; 12(3): 111-116

Comparison of two different anesthesia methods for relief of pain during transrectal ultrasound-guided prostate biopsy: Perianal infiltration anesthesia vs topical lidocaine cream

Ferhat Ates, Temucin Senkul, Hasan Soydan, Ilker Akyol, Huseyin Sen, Ercan Malkoc, Kadir Baykal.

We aimed to compare the effects of peri- anal infiltration vs topical anesthesia for relief of pain during transrectal ultrasound guided prostate biopsy. One-hundred-eighty patients, who were planned to undergo prostate biopsy due to either increased prostate specific antigen (PSA) levels or abnormal digital rectal examination, were ran- domized into two groups prospectively. First group received perianal lidocaine infiltration in four quadrants and topical lidocaine anesthesia was applied in the second group. Pain during penetra- tion of the ultrasound probe and during biopsy was assessed with visual analogue scale. Mann- Whitney-U test and multivariant analysis were used in statistical analysis. Both groups comprised 90 patients. Mean values for age, PSA and prostate volume were 64.5 years, 6.9 ng/ml and 54 cc; 65.5 years, 6.5 ng/ml and 54 cc in the groups, respec- tively (p>0.05). Pain scores during probe penetra- tion and biopsy were 1.681.05 and 3.460.94 in the first group; 1.060.74 and 2.540.90 in the sec- ond group. Although pain scores regarding probe penetration were similar between groups (p=0.092), pain during biopsy was found to be less in the second group (p=0.002). Perianal infiltration anesthesia seems to be effective as topical anesthe- sia in decreasing pain during penetration of the ultrasound probe but less effective during biopsy.

Key words: Anesthesia, biopsy, pain, prostate.

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