Department of Urology, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 8, Singapore 119228.
Singapore Med J. 2011 Oct;52(10):752-7.
This study aimed to evaluate the risk of complications for patients who received periprosthetic nerve block (PPNB) with one percent lignocaine before transrectal ultrasonography (TRUS) biopsy of the prostate.
From 2008 to 2009, data on 526 consecutive patients who underwent prostate biopsy was prospectively recorded and analysed. 475 (90.3 percent) patients received PPNB with 10 ml of one percent lignocaine (Group 1), which was carried out under TRUS-guidance and prior to biopsy. 51 (9.7 percent) patients received diclofenac (100 mg) intramuscular injections or no analgesia (Group 2). Complications were defined as any adverse effects after biopsy. Serious complications were defined as those requiring hospitalisation or invasive/operative procedures for treatment.
At baseline, both groups were comparable. The mean prostate-specific antigen level in Group 1 was higher than that in Group 2 (48.6 +/- 13.8 versus 19.0 +/- 4.3 ng/ml; p-value is 0.04). There was no perioperative mortality. Post-procedural complications were reported in 23.4 percent (n is 111) of patients in Group 1 and 25.5 percent (n is 13) in Group 2 (p-value is 0.27). Serious complications were reported in 2.5 percent (n is 12) and 7.1 percent (n is 3) of Group 1 and 2 patients (p-value is 0.10), respectively. Both univariable and logistic regression revealed age below 65 years and pre-procedure complaints of lower urinary tract symptoms as independent predictors for complications (p-values are 0.02 and 0.006, respectively).
PPNB with one percent lignocaine is a safe analgesic procedure to perform in patients undergoing TRUS biopsy.
本研究旨在评估在经直肠超声（TRUS）前列腺活检前行周围神经阻滞（PPNB）给予 1%利多卡因的患者发生并发症的风险。
2008 年至 2009 年，前瞻性记录并分析了 526 例连续接受前列腺活检的患者的数据。475 例（90.3%）患者接受了 10ml 1%利多卡因的 PPNB（组 1），该操作在 TRUS 引导下于活检前进行。51 例（9.7%）患者接受了双氯芬酸钠（100mg）肌内注射或无镇痛（组 2）。并发症定义为活检后出现的任何不良反应。严重并发症定义为需要住院或侵入性/手术治疗的并发症。
基线时，两组具有可比性。组 1 的平均前列腺特异性抗原水平高于组 2（48.6±13.8 与 19.0±4.3ng/ml；p 值为 0.04）。无围手术期死亡。组 1 有 23.4%（n 是 111）的患者报告术后并发症，组 2 有 25.5%（n 是 13）的患者报告术后并发症（p 值为 0.27）。组 1 和 2 分别有 2.5%（n 是 12）和 7.1%（n 是 3）的患者报告严重并发症（p 值分别为 0.10 和 0.006）。单变量和逻辑回归均显示年龄低于 65 岁和术前下尿路症状的主诉是并发症的独立预测因素（p 值分别为 0.02 和 0.006）。
在接受 TRUS 活检的患者中，给予 1%利多卡因的 PPNB 是一种安全的镇痛方法。
