Kim Do Kyung, Hah Yoon Soo, Kim Jong Won, Koo Kyo Chul, Lee Kwang Suk, Hong Chang Hee, Chung Byung Ha, Cho Kang Su
Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul 04401, Korea.
Department of Urology, Daegu Catholic University Medical Center, Daegu 42472, Korea.
J Clin Med. 2019 Apr 24;8(4):557. doi: 10.3390/jcm8040557.
We evaluated whether pelvic plexus block (PPB) is superior to periprostatic nerve block (PNB) for pain control during transrectal ultrasonography (TRUS)-guided prostate biopsy (PBx). A prospective, double-blind, randomized, controlled study was performed at a single center; 46 patients were enrolled and randomly allocated into two groups: PPB (n = 23) and PNB (n = 23). The visual analogue scale (VAS) was used; pain scores were measured four times: during local anesthesia, probe insertion, sampling procedures, and at 15 min post procedures. No significant differences were observed in VAS scores during local anesthesia (2.30 for PPB vs. 2.65 for PNB, 0.537) or during probe insertion (2.83 for PPB vs. 2.39 for PNB, 0.569). Similarly, no differences in VAS scores were detected during the sampling procedures (2.83 for PPB vs. 2.87 for PNB, 0.867) and at 15 min post procedures (1.39 for PPB vs. 1.26 for PNB, 0.631). No major complications were noted in either group. Both PPB and PNB are comparably effective and safe methods for PBx related pain relief, and PPB is not superior to PNB. Local anesthetic method could be selected based on the preference and skill of the operator.
我们评估了在经直肠超声（TRUS）引导下的前列腺活检（PBx）过程中，盆腔神经丛阻滞（PPB）在疼痛控制方面是否优于前列腺周围神经阻滞（PNB）。在单一中心进行了一项前瞻性、双盲、随机对照研究；46例患者入组并随机分为两组：PPB组（n = 23）和PNB组（n = 23）。采用视觉模拟评分法（VAS）；在局部麻醉、探头插入、采样过程以及术后15分钟时测量疼痛评分。在局部麻醉期间（PPB组为2.30，PNB组为2.65，P = 0.537）或探头插入期间（PPB组为2.83，PNB组为2.39，P = 0.569），VAS评分未观察到显著差异。同样，在采样过程中（PPB组为2.83，PNB组为2.87，P = 0.867）和术后15分钟时（PPB组为1.39，PNB组为1.26，P = 0.631），VAS评分也未检测到差异。两组均未出现重大并发症。PPB和PNB在缓解PBx相关疼痛方面都是同等有效且安全的方法，并且PPB并不优于PNB。可根据操作者的偏好和技术选择局部麻醉方法。
