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. 2018 Feb 20:23:17.
doi: 10.4103/jrms.JRMS_639_17. eCollection 2018.

A comparison of pain control and complications using three different ways of anesthesia in patients undergoing transrectal ultrasound-guided prostate biopsy

Hamid Mazdak  1 , Amir Mohamad Abtahi  1 , Fatemeh Momeni  2 , Mohammad Hossein Izadpanahi  1
Affiliations

A comparison of pain control and complications using three different ways of anesthesia in patients undergoing transrectal ultrasound-guided prostate biopsy

Hamid Mazdak et al. J Res Med Sci. .

Abstract

Background: We aim to compare the degree of pain control and complications in three types of anesthesia using periprostatic nerve block (PPNB) plus intrarectal local anesthesia (IRLA), low-dose spinal anesthesia, and intravenous (IV) sedation in patients undergoing transrectal ultrasound (TRUS)-guided prostate biopsy.

Materials and methods: In this clinical trial study, 106 patients were participated from December 2015 to December 2016 at Alzahra Hospital, Isfahan, Iran. Patients were randomly allocated into three groups to receive PPNB plus IRLA (n = 36), low-dose spinal anesthesia (n = 35) and IV sedation (n = 35) before TRUS-guided prostate biopsy. Pain scores were recorded using a 10 point visual analog scale right after the biopsy was done. Early and late complications were assessed using a questionnaire after the procedure and in follow-up of patients.

Results: Overall, the pain score in the low-dose spinal anesthesia group was significantly lower than PPNB plus IRLA and IV sedation groups (P < 0.001). The differences in pain scores between PPNB plus IRLA group and IV sedation group were not significant (P = 0.30). Urinary retraction and fever were significantly more frequent in low-dose spinal anesthesia and IV sedation, retrospectively (P = 0.04, P = 0.03). No significant difference in late complications was found among the groups.

Conclusion: This study demonstrates that low-dose spinal anesthesia is superior to PPNB plus IRLA and IV sedation in terms of pain controlling and was associated with higher tolerance of the examination and patient comfort.

Keywords: Intravenous sedation; nerve block; pain; prostate biopsy; spinal anesthesia; trans rectal ultrasonography.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Study flow diagram
See this image and copyright information in PMC

References

    1. Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T, et al. EAU guidelines on prostate cancer. Part 1: Screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol. 2014;65:124–37. - PubMed
    1. Machado MT, Aragão AJ, Rodrigues AO, Wroclawski ER. Periprostatic local anesthesia in transrectal ultrasound-guided prostate biopsy: Is it possible to improve pain tolerance? Int Braz J Urol. 2002;28:323–9. - PubMed
    1. Bjurlin MA, Carter HB, Schellhammer P, Cookson MS, Gomella LG, Troyer D, et al. Optimization of initial prostate biopsy in clinical practice: Sampling, labeling and specimen processing. J Urol. 2013;189:2039–46. - PMC - PubMed
    1. Presti JC, Jr, Chang JJ, Bhargava V, Shinohara K. The optimal systematic prostate biopsy scheme should include 8 rather than 6 biopsies: Results of a prospective clinical trial. J Urol. 2000;163:163–6. - PubMed
    1. Temiz MZ, Kandirali E, Colakerol A, Tuken M, Semercioz A. Local anesthesia type affects cancer detection rate in transrectal ultrasound guided prostate biopsy. Int Braz J Urol. 2015;41:859–63. - PMC - PubMed