Başar Hülya, Başar M Murad, Ozcan Saziye, Akpinar Serpil, Başar Halil, Batislam Ertan
Department of Anesthesiology and Reanimation, University of Kirikkale, Kirikkale, Turkey.
Scand J Urol Nephrol. 2005;39(2):130-4. doi: 10.1080/00365590510007810.
The aims of the present study were to evaluate the efficacy of eutectic mixture of local anesthetics (EMLA) cream in transrectal-guided prostate biopsy and to compare its effect with that of other injectable anesthetic procedures.
Eighty male patients with prostate-specific antigen (PSA) levels > 4 ng/ml or who had prostate nodules on digital rectal examination were randomly divided into four groups. In Group 1 (controls), prostate biopsy was performed after application of a placebo cream. In Group 2, local surface anesthesia with EMLA cream was performed 15 min before biopsy. Periprosthetic nerve blockade was performed with 1% prilocaine and 1% lidocaine in Groups 3 and 4, respectively. Pain was evaluated using a visual analog scale (VAS) after each core biopsy. In addition, blood pressure, heart rate and oxygen saturations were recorded after each biopsy and then at 5-min intervals for 15 min.
Average VAS scores in Groups 1-4 were 5.5, 2.9, 2.4 and 2.2, respectively. There was a statistically significant difference in VAS scores between the treatment groups and the placebo group (p = 0.000). There were no statistically significant differences in VAS scores between the three treatment groups (p2-3 = 0.126, p2-4 = 0.303, p3-4 = 0.537). We detected no statistically significant differences between the groups based on the hemodynamic data (pMAP = 0.899). Moreover, these measurements did not show statistically significant changes with time in any of the groups (p > 0. 05).
Intrarectal application of EMLA cream provides equal anesthesia to periprostatic nerve blockade with prilocaine and lidocaine.
本研究旨在评估复方利多卡因（EMLA）乳膏在经直肠引导前列腺活检中的疗效，并将其效果与其他注射麻醉方法进行比较。
80例前列腺特异性抗原（PSA）水平>4 ng/ml或直肠指检发现前列腺结节的男性患者被随机分为四组。第1组（对照组）在涂抹安慰剂乳膏后进行前列腺活检。第2组在活检前15分钟用EMLA乳膏进行局部表面麻醉。第3组和第4组分别用1%丙胺卡因和1%利多卡因进行前列腺周围神经阻滞。每次取芯活检后使用视觉模拟评分法（VAS）评估疼痛程度。此外，每次活检后记录血压、心率和血氧饱和度，然后每隔5分钟记录一次，共记录15分钟。
第1 - 4组的平均VAS评分分别为5.5、2.9、2.4和2.2。治疗组与安慰剂组的VAS评分存在统计学显著差异（p = 0.000）。三个治疗组之间的VAS评分无统计学显著差异（p2 - 3 = 0.126，p2 - 4 = 0.303，p3 - 4 = 0.537）。基于血流动力学数据，我们未发现组间存在统计学显著差异（pMAP = 0.899）。此外，这些测量结果在任何一组中均未显示出随时间的统计学显著变化（p > 0.05）。
直肠内应用EMLA乳膏与用丙胺卡因和利多卡因进行前列腺周围神经阻滞提供的麻醉效果相同。
