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Analgesic Efficacy of Intrarectal Instillation of Lidocaine Gel prior to Transrectal Ultrasound Guided Prostate Biopsy: A Prospective Randomized Trial |
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Tae Jin Yun, M.D. Hak Jong Lee, M.D.*, Seung Hyup Kim, M.D.,Sang Eun Lee, M.D.**, Seok-Soo Byun, M.D.**, Jeong Yeon Cho, M.D., Chang Kyu Seong, M.D.*** |
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Seoul National University Hospital *Seoul National University Bundang Hospital ** Department of Urology,Seoul National University Bundang Hospital *** Seoul National University Borame Hospital |
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PURPOSE : To assess the analgesic efficacy of intrarectal lidocaine gel instillation prior to periprostatic nerve block
during transrectal, ultrasound-guided prostate biopsies.
MATERIALS and METHODS : Between March 2004 and October 2004, 203 consecutive patients for prostate biopsies
were randomized into two groups. In 90 patients of group A, 10ml of 2% lidocaine gel was instilled intrarectally
10 minutes prior to periprostatic neurovascular bundle block, while 113 patients of group B received only
periprostatic neurovascular bundle block without lidocaine gel instillation. Pain was assessed with the visual
analogue pain scale, during periprostatic neurovascular bundle block (VAS 1), during the biopsy procedures
(VAS 2) and 20 minutes after the procedure (VAS 3). The difference in VAS scores between patients in the two
groups was evaluated with the unpaired t-test, with p < 0.05 considered significant.
RESULTS : Patients in group A experienced statistically less pain during transrectal ultrasound guided prostate biopsy
(VAS 2, 2.994 versus 3.903, p < 0.01). However, no significant difference in VAS values could be demonstrated
during periprostatic neurovascular bundle block (VAS 1, 4.761 versus 5.133, p > 0.05) or at after 20 minutes after
the procedure (VAS 3, 0.9778 versus 1.257, p > 0.05).
CONCLUSION : Intrarectal instillation of lidocaine gel leads to significant additional analgesic efficacy during the
biopsy procedure. It is a simple, safe and rapid technique that should be considered in all patients undergoing
TRUS guided prostate biopsy. |
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Keyword : Prostate, Cancer, Ultrasound, Biopsies, Pain, Analgesics |
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pdf파일 : 081-85윤태진.pdf
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