Ankara Numune Training and Research Hospital, Department of Urology, Ankara, Turkey.
Ankara Numune Training and Research Hospital, Department of Anesthesiology, Ankara, Turkey.
Urol J. 2020 Mar 14;17(6):597-601. doi: 10.22037/uj.v0i0.5503.
To evaluate the efficacy of caudal regional anesthesia and local anesthesia methods in prostate biopsy applied under transrectal ultrasonography. Matherials and Methods: This prospective study included a total of 160 patients randomly separated into 4 equal groups as intrarectal local anesthesia (IRLA), periprostatic local anesthesia (PPLA), combined local anesthesia (IRLA+PPLA), and caudal regional anesthesia (CRA). The patients were evaluated using the pain scores on a visual analog scale.
The pain score during anesthesia induction was significantly higher in the CRA group than in the IRLA and IRLA+PPLA groups (p<0.001). The pain score during entry of the probe to the rectum and movement was significantly lower in the CRA group than the IRLA groups (p=0.014). The pain score on penetration of the needle to the prostate and at 30 mins after the biopsy was significantly higher in the IRLA group (p<0.001). At 2 hours after the biopsy, the pain score in the CRA group was significantly lower than IRLA groups (p=0.015).
The PPLA alone can be applied more quickly than CRA, causes less pain during the application, and has similar efficacy in reducing pain during and after the prostate biopsy procedure.
评估经直肠超声引导下前列腺活检中应用的骶管区域麻醉和局部麻醉方法的疗效。
本前瞻性研究共纳入 160 例患者，随机分为 4 组，分别为直肠内局部麻醉（IRLA）、前列腺周围局部麻醉（PPLA）、联合局部麻醉（IRLA+PPLA）和骶管区域麻醉（CRA）。采用视觉模拟评分法评估患者的疼痛评分。
CRA 组麻醉诱导时的疼痛评分明显高于 IRLA 和 IRLA+PPLA 组（p<0.001）。CRA 组探针进入直肠和移动时的疼痛评分明显低于 IRLA 组（p=0.014）。IRLA 组穿刺针进入前列腺和活检后 30 分钟的疼痛评分明显升高（p<0.001）。活检后 2 小时，CRA 组的疼痛评分明显低于 IRLA 组（p=0.015）。
与 CRA 相比，单独应用 PPLA 可更快起效，应用过程中疼痛更小，在减轻前列腺活检过程中和之后的疼痛方面具有相似的疗效。
