Caudal block anesthesia for transrectal prostate biopsy

Abstract

Objective: Transrectal prostate biopsy is a potentially painful procedure. Our service has significant experience with caudal anesthesia for perianal procedures. This study is aimed to determine the effectiveness of caudal anesthesia for transrectal prostate biopsy.

Patients and methods: Seventy consecutive patients undergoing transrectal prostate biopsy were entered into the study. The patients were requested to complete a questionnaire structured to assess the pain felt during the procedure using the visual analog score (VAS). The effectiveness of the caudal anesthesia was determined by the anesthesia of the perineum and the laxity of the anal sphincter. Complications from the procedures were recorded.

Results: All the patients completed and returned the questionnaire. The average age of the respondents is 65.8 years. Among the 34 patients with caudal block, effective anesthesia was achieved in 28 patients and ineffective in six patients. However, the mean VAS for the pain from transrectal prostate biopsy was 1.49 +/- 1.93 SD (range 0-6.0) for the patients with effective caudal anesthesia and 8.02 +/- 1.79 SD (range 5.0-10.0) for patients with no caudal anesthesia. There was a reduced requirement for analgesics after prostate biopsy for patients with effective caudal anesthesia. Three patients (8.8%) had minor complications (transient dizziness) following the injection of the anesthetic into the caudal epidural space.

Conclusion: Satisfactory analgesia for transrectal prostate biopsy can be achieved with the use of CA and it results in better cooperation of the patient during the procedure.