Wang Na, Fu Yaowen, Ma Haichun, Wang Jinguo, Gao Yang
Na Wang, Department of Anesthesiology, The First Hospital of Jilin University, Jilin, China.
Yaowen Fu, Department of Urology, The First Hospital of Jilin University, Jilin, China.
Pak J Med Sci. 2016 Jul-Aug;32(4):978-82. doi: 10.12669/pjms.324.9823.
To compare caudal block with intrarectal local anesthesia plus periprostatic nerve block for transrectal ultrasound guided prostate biopsy.
One hundred and ninety patients scheduled for transrectal ultrasound guided prostate biopsy were randomized equally into Group-A who received caudal block (20 ml 1.2% lidocaine) and Group-B who received intrarectal local anesthesia (0.3% oxybuprocaine cream) plus periprostatic nerve block (10 ml 1% lidocaine plus 0.5% ropivacaine) before biopsy. During and after the procedure, the patients rated the level of pain/discomfort at various time points. Complications during the whole study period and the patient overall satisfaction were also evaluated.
More pain and discomfort was detected during periprostatic nerve block than during caudal block. Pain and discomfort was significantly lower during prostate biopsy and during the manipulation of the probe in the rectum in Group-A than in Group-B. No significant differences were detected in the pain intensity after biopsy and side effects between the two groups.
Caudal block provides better anesthesia than periprostatic nerve block plus intrarectal local anesthesia for TRUS guided prostate biopsy without an increase of side effects.
比较骶管阻滞与直肠内局部麻醉加前列腺周围神经阻滞用于经直肠超声引导下前列腺穿刺活检的效果。
将190例计划行经直肠超声引导下前列腺穿刺活检的患者平均随机分为A组（接受骶管阻滞，20 ml 1.2%利多卡因）和B组（在活检前接受直肠内局部麻醉，0.3%奥布卡因乳膏）加前列腺周围神经阻滞（10 ml 1%利多卡因加0.5%罗哌卡因）。在操作过程中和操作后，患者对不同时间点的疼痛/不适程度进行评分。还评估了整个研究期间的并发症和患者总体满意度。
前列腺周围神经阻滞期间比骶管阻滞期间检测到更多的疼痛和不适。A组在前列腺活检期间和直肠内探头操作期间的疼痛和不适明显低于B组。两组活检后疼痛强度和副作用方面未检测到显著差异。
对于经直肠超声引导下前列腺穿刺活检，骶管阻滞比前列腺周围神经阻滞加直肠内局部麻醉提供更好的麻醉效果，且不增加副作用。
