Abstract
Objectives: To compare pain control results between periprostatic nerve block alone and combined with topical prilocaine-lidocaine cream as local anesthesia of prostate biopsy. Methods: Three hundred patients were randomized to receive PNB (group 1), topical anesthesia of the anal ring, anal canal, and anterior rectal wall combined with PNB (group 2) and placebo (group 3). Patients were asked to use scale of 0-10 to complete a visual analogue scale questionnaire about pain during probe insertion (VAS1), periprostatic infiltration (VAS2), and cores (VAS3). Results: Pain during probe insertion in group 2 was significantly less than in groups 1 and 3 (VAS1, 0.29 vs. 1.46 and 1.48; p <0.0001). Pain during periprostatic infiltration was also reduced in group 2 compared with group 1 (VAS2, 1.06 vs. 2.39; p <0.0001). Pain control was similar during biopsy in the PNB and combined groups (VAS3, 0.43 vs. 0.37; p = 0.77) and was superior to group 3 (VAS3, 3.02; p <0.0001). In younger patients (cut off, median age 67 yr) these differences were still significant between groups 1 and 2 (VAS1, 1.95 vs.0.31; p <0.0001 and VAS2, 2.97 vs. 1,15; p <0.0001), but not in older patients (VAS1, 0.91 vs. 0.28; p = 0.06; VAS2, 1.52 vs. 0,92; p = 0.06). Vagal symptoms were registered in 36 (12%) patients in all groups. Sepsis occurred in one group 1 patient and in one group 2 patient. Rectal bleeding was observed in one group 2 patient. Conclusion: Combined prilocaine-lidocaine cream topically placed with PNB is superior to PNB alone and may be of maximum benefit for younger patients.
| Original language | English |
|---|---|
| Pages (from-to) | 967-975 |
| Number of pages | 9 |
| Journal | European Urology |
| Volume | 53 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 2008 |
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Keywords
- Anesthesia
- Biopsy
- Prostate cancer
ASJC Scopus subject areas
- Urology
Cite this
Topical Prilocaine-Lidocaine Cream Combined with Peripheral Nerve Block Improves Pain Control in Prostatic Biopsy : Results from a Prospective Randomized Trial. / Raber, Marco; Scattoni, Vincenzo; Roscigno, Marco; Dehò, Federico; Briganti, Alberto; Salonia, Andrea; Gallina, Andrea; Di Girolamo, Valerio; Montorsi, Francesco; Rigatti, Patrizio.
In: European Urology, Vol. 53, No. 5, 05.2008, p. 967-975.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Topical Prilocaine-Lidocaine Cream Combined with Peripheral Nerve Block Improves Pain Control in Prostatic Biopsy
T2 - Results from a Prospective Randomized Trial
AU - Raber, Marco
AU - Scattoni, Vincenzo
AU - Roscigno, Marco
AU - Dehò, Federico
AU - Briganti, Alberto
AU - Salonia, Andrea
AU - Gallina, Andrea
AU - Di Girolamo, Valerio
AU - Montorsi, Francesco
AU - Rigatti, Patrizio
PY - 2008/5
Y1 - 2008/5
N2 - Objectives: To compare pain control results between periprostatic nerve block alone and combined with topical prilocaine-lidocaine cream as local anesthesia of prostate biopsy. Methods: Three hundred patients were randomized to receive PNB (group 1), topical anesthesia of the anal ring, anal canal, and anterior rectal wall combined with PNB (group 2) and placebo (group 3). Patients were asked to use scale of 0-10 to complete a visual analogue scale questionnaire about pain during probe insertion (VAS1), periprostatic infiltration (VAS2), and cores (VAS3). Results: Pain during probe insertion in group 2 was significantly less than in groups 1 and 3 (VAS1, 0.29 vs. 1.46 and 1.48; p <0.0001). Pain during periprostatic infiltration was also reduced in group 2 compared with group 1 (VAS2, 1.06 vs. 2.39; p <0.0001). Pain control was similar during biopsy in the PNB and combined groups (VAS3, 0.43 vs. 0.37; p = 0.77) and was superior to group 3 (VAS3, 3.02; p <0.0001). In younger patients (cut off, median age 67 yr) these differences were still significant between groups 1 and 2 (VAS1, 1.95 vs.0.31; p <0.0001 and VAS2, 2.97 vs. 1,15; p <0.0001), but not in older patients (VAS1, 0.91 vs. 0.28; p = 0.06; VAS2, 1.52 vs. 0,92; p = 0.06). Vagal symptoms were registered in 36 (12%) patients in all groups. Sepsis occurred in one group 1 patient and in one group 2 patient. Rectal bleeding was observed in one group 2 patient. Conclusion: Combined prilocaine-lidocaine cream topically placed with PNB is superior to PNB alone and may be of maximum benefit for younger patients.
AB - Objectives: To compare pain control results between periprostatic nerve block alone and combined with topical prilocaine-lidocaine cream as local anesthesia of prostate biopsy. Methods: Three hundred patients were randomized to receive PNB (group 1), topical anesthesia of the anal ring, anal canal, and anterior rectal wall combined with PNB (group 2) and placebo (group 3). Patients were asked to use scale of 0-10 to complete a visual analogue scale questionnaire about pain during probe insertion (VAS1), periprostatic infiltration (VAS2), and cores (VAS3). Results: Pain during probe insertion in group 2 was significantly less than in groups 1 and 3 (VAS1, 0.29 vs. 1.46 and 1.48; p <0.0001). Pain during periprostatic infiltration was also reduced in group 2 compared with group 1 (VAS2, 1.06 vs. 2.39; p <0.0001). Pain control was similar during biopsy in the PNB and combined groups (VAS3, 0.43 vs. 0.37; p = 0.77) and was superior to group 3 (VAS3, 3.02; p <0.0001). In younger patients (cut off, median age 67 yr) these differences were still significant between groups 1 and 2 (VAS1, 1.95 vs.0.31; p <0.0001 and VAS2, 2.97 vs. 1,15; p <0.0001), but not in older patients (VAS1, 0.91 vs. 0.28; p = 0.06; VAS2, 1.52 vs. 0,92; p = 0.06). Vagal symptoms were registered in 36 (12%) patients in all groups. Sepsis occurred in one group 1 patient and in one group 2 patient. Rectal bleeding was observed in one group 2 patient. Conclusion: Combined prilocaine-lidocaine cream topically placed with PNB is superior to PNB alone and may be of maximum benefit for younger patients.
KW - Anesthesia
KW - Biopsy
KW - Prostate cancer
UR - http://www.scopus.com/inward/record.url?scp=41149128904&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=41149128904&partnerID=8YFLogxK
U2 - 10.1016/j.eururo.2007.09.005
DO - 10.1016/j.eururo.2007.09.005
M3 - Article
C2 - 17904278
AN - SCOPUS:41149128904
VL - 53
SP - 967
EP - 975
JO - European Urology
JF - European Urology
SN - 0302-2838
IS - 5
ER -