Anastasi Giuseppina, Subba Enrica, Pappalardo Rosa, Macchione Luciano, Ricotta Gioacchino, Muscarà Graziella, Lembo Francesco, Magno Carlo
Unit of Urology, Department of Human Pathology, University of Messina, Messina,.
Arch Ital Urol Androl. 2016 Dec 30;88(4):308-310. doi: 10.4081/aiua.2016.4.308.
Transrectal Ultrasound (TRUS) guided prostate biopsy is regarded as the gold standard for prostate cancer diagnosis. The majority of patients perceive TRUS-guided prostate biopsy as a physically and psychologically traumatic experience. We aimed to compare in this paper the efficacy of three different anesthesia techniques to control the pain during the procedure.
150 patients who underwent transrectal ultrasound (TRUS) guided prostate biopsy were randomly divided into three groups. Group A included 50 patients who received one hour before the procedure a mixture of 2.5% lidocaine and 2.5% prilocaine, Group B: 50 patients who received intrarectal local anesthetic administration (lidocaine 5 ml 10%) and lidocaine local spray 15 % and Group C included 50 patients who received periprostatic block anesthesia (lidocaine 10 ml 10%). Visual analogue scale (VAS) of patients in different groups was evaluated at the end of the biopsy and 30 minutes after the procedure.
The VAS of patients in Group A was 1.32 ± 0.65 (VAS I) and 2.47 ± 0.80 (VAS II). In group B the VAS of patients was 1.09 ± 0.47 (VAS I) and 1.65 ± 0.61 (VAS II). In group C the VAS of patients was 2.63 ± 0.78 (VAS I) and 1.70 ± 0.85 (VAS II). There was no statistically significant difference in term of VAS I between group A and B. A statistically significant difference was determined in terms of VAS II between group A and B. There was no statistically significant difference in term of VAS between group B and C.
The most effective of the three methods for pain control we used was intrarectal local anesthetic administration and lidocaine local spray 15% that enables an ideal patient comfort.
经直肠超声（TRUS）引导下的前列腺活检被视为前列腺癌诊断的金标准。大多数患者认为TRUS引导下的前列腺活检是一种身体和心理上的创伤性经历。我们旨在比较本文中三种不同麻醉技术在手术过程中控制疼痛的效果。
150例行经直肠超声（TRUS）引导下前列腺活检的患者被随机分为三组。A组包括50例患者，在手术前1小时接受2.5%利多卡因和2.5%丙胺卡因的混合液；B组：50例患者接受直肠内局部麻醉给药（10%利多卡因5ml）和15%利多卡因局部喷雾；C组包括50例患者接受前列腺周围阻滞麻醉（10%利多卡因10ml）。在活检结束时和手术后30分钟评估不同组患者的视觉模拟评分（VAS）。
A组患者的VAS为1.32±0.65（VAS I）和2.47±0.80（VAS II）。B组患者的VAS为1.09±0.47（VAS I）和1.65±0.61（VAS II）。C组患者的VAS为2.63±0.78（VAS I）和1.70±0.85（VAS II）。A组和B组在VAS I方面无统计学显著差异。A组和B组在VAS II方面有统计学显著差异。B组和C组在VAS方面无统计学显著差异。
我们使用的三种疼痛控制方法中最有效的是直肠内局部麻醉给药和15%利多卡因局部喷雾，可使患者达到理想的舒适度。
