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. 2006 Mar;88(2):218-21.
doi: 10.1308/003588406X95048.

The rectal administration of lignocaine gel and periprostatic lignocaine infiltration during transrectal ultrasound-guided prostate biopsy provides effective analgesia

E J Siddiqui  1 , S Ali, S Koneru
Affiliations

The rectal administration of lignocaine gel and periprostatic lignocaine infiltration during transrectal ultrasound-guided prostate biopsy provides effective analgesia

E J Siddiqui et al. Ann R Coll Surg Engl. 2006 Mar.

Abstract

Introduction: Transrectal ultrasound guided prostate needle biopsy (TRUS) is the standard procedure to diagnose or exclude prostate cancer. This procedure can be associated with significant discomfort, both on insertion of the ultrasound probe as well as on taking the biopsy. We evaluated a new technique for pain relief during TRUS biopsy.

Patients and methods: In Group 1 (n = 60), the biopsies were taken without any analgesia. In Group 2 (n = 60), 11 ml of Instillagel (2% lignocaine) was administered rectally prior to probe insertion and 5 ml of 1% lignocaine periprostatic injection was administered before taking the biopsy. The discomfort encountered during the procedure was graded by the patient on a scale ranging from no discomfort to mild, moderate and severe pain.

Results: In Group 2, there was a marked reduction in the pain experienced during the procedure. The Chi-squared test for trend showed a significant association between the rectal administration of local anaesthetic gel and reduction in pain on probe insertion (P = 0.0001). There was also a significant association between the use of periprostatic lignocaine injection and reduction in pain on taking the biopsy (P < 0.0001).

Conclusions: The use of lignocaine gel prior to probe insertion and periprostatic infiltration of lignocaine before taking the needle biopsy significantly reduces the pain experienced by the patient during TRUS-guided prostate biopsy.

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Figures

Figure 1
Figure 1
Comparison of pain score in the non-analgesic and analgesic group on probe insertion.
Figure 2
Figure 2
Comparison of pain score in non-analgesic and analgesic group on TRUS biopsy.
Figure 3
Figure 3
Comparison between current and previous biopsy pain score in the same patients.
See this image and copyright information in PMC

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