Berger Andreas P, Frauscher Ferdinand, Halpern Ethan J, Spranger Robert, Steiner Hannes, Bartsch Georg, Horninger Wolfgang
Department of Urology, University of Innsbruck, Innsbruck, Austria.
Urology. 2003 Mar;61(3):585-8. doi: 10.1016/s0090-4295(02)02406-8.
To evaluate the effect of periprostatic infiltration with local anesthesia on the level of discomfort associated with transrectal ultrasound-guided needle biopsy of the prostate. Transrectal ultrasound-guided needle biopsy of the prostate is the standard procedure to diagnose prostate cancer.
A prospective, randomized, double-blind study was performed on 100 men referred for biopsy of the prostate. Fifty subjects were randomized to periprostatic injection of 10 mL of 2% lidocaine solution without epinephrine, and 50 were randomized to injection of placebo (10 mL of 0.9% NaCl). Each subject completed three 10-point visual analog scales for pain after a series of 15 needle biopsies. Pain was rated during the biopsy, diagnostic investigation, and injection of lidocaine.
Patients who received local anesthesia had significantly lower visual analog scale scores compared with the group without lidocaine during the biopsy (mean score 0.76 versus 3.62, P <0.001) and diagnostic examination (mean score 1.08 versus 1.86, P = 0.025). Lidocaine injection caused no adverse effects.
Periprostatic injection of lidocaine represents a simple and safe procedure that significantly reduces discomfort during probe manipulation and biopsy. We recommend this procedure in men undergoing transrectal ultrasound-guided prostate biopsy.
评估前列腺周围局部麻醉浸润对经直肠超声引导下前列腺穿刺活检相关不适程度的影响。经直肠超声引导下前列腺穿刺活检是诊断前列腺癌的标准程序。
对100名因前列腺活检前来就诊的男性进行了一项前瞻性、随机、双盲研究。50名受试者被随机分配接受前列腺周围注射10毫升不含肾上腺素的2%利多卡因溶液，另外50名被随机分配接受安慰剂注射（10毫升0.9%氯化钠溶液）。在进行一系列15次穿刺活检后，每个受试者完成三个10分制的视觉模拟量表来评估疼痛程度。在活检、诊断检查以及注射利多卡因过程中对疼痛进行评分。
在活检期间（平均得分0.76对3.62，P<0.001）和诊断检查期间（平均得分1.08对1.86，P = 0.025），接受局部麻醉的患者视觉模拟量表得分显著低于未使用利多卡因的组。注射利多卡因未引起不良反应。
前列腺周围注射利多卡因是一种简单且安全的操作方法，可显著减轻探头操作和活检过程中的不适。我们建议对接受经直肠超声引导下前列腺穿刺活检的男性采用此方法。
