Ding Xue-Fei, Luan Yang, Wang Fei, Xu Yao-Zong, Guo Cheng-Hao, Zhu Liang-Yong
Clinical Medical College, Yangzhou University, Yangzhou, China.
Quant Imaging Med Surg. 2020 Nov;10(11):2125-2132. doi: 10.21037/qims-20-369.
Our study aims to evaluate the anesthetic efficacy of multiparametric magnetic resonance imaging/transrectal ultrasound (mpMRI/TRUS) fusion-guided targeted periprostatic nerve block (PNB) for transperineal template-guided prostate biopsy (TTPB).
The patients who underwent mpMRI/TRUS fusion-guided prostate biopsy from May 2018 to March 2019 were randomized into two groups using a random number table. The intervention group (n=47) and the control group (n=45) received targeted PNB and traditional PNB, respectively. Visual analog scale (VAS) and visual numeric scale (VNS) scores were used to assess the patients' pain and quantify their satisfaction.
The total detection rate for prostate cancer was 45.7%, with a comparable positive rate between the intervention group (42.6%) and the control group (48.9%), which meant there was no significant difference between the groups (P=0.542). Patient age, prostate-specific antigen, prostate volume, suspicious lesions on mpMRI, number of cores, operation time, and biopsy time were comparable between the groups. The VAS scores during biopsy were significantly lower in the intervention group than in the control group [2 (1 to 3) . 2 (1 to 4), P=0.019]. Conversely, the VNS scores during biopsy were higher in the intervention group [3 (2 to 4) . 3 (2 to 3), P=0.015]. There were no significant differences in the pain scores or the satisfaction scores at 30 min after the procedure between the two groups. There were no significant differences between the groups for complications, such as hematuria, urinary retention, infection, hemospermia, and vasovagal reaction (P>0.05).
Targeted PNB significantly relieved the pain and did not increase the incidence of complications for patients when compared with traditional PNB.
我们的研究旨在评估多参数磁共振成像/经直肠超声（mpMRI/TRUS）融合引导下的靶向前列腺周围神经阻滞（PNB）用于经会阴模板引导前列腺穿刺活检（TTPB）的麻醉效果。
2018年5月至2019年3月接受mpMRI/TRUS融合引导前列腺穿刺活检的患者，使用随机数字表随机分为两组。干预组（n = 47）和对照组（n = 45）分别接受靶向PNB和传统PNB。采用视觉模拟量表（VAS）和视觉数字量表（VNS）评分评估患者疼痛程度并量化其满意度。
前列腺癌总检出率为45.7%，干预组（42.6%）和对照组（48.9%）的阳性率相当，两组间差异无统计学意义（P = 0.542）。两组患者的年龄、前列腺特异性抗原、前列腺体积、mpMRI上的可疑病变、穿刺针数、手术时间和活检时间相当。干预组活检期间的VAS评分显著低于对照组[2（1至3）. 2（1至4），P = 0.019]。相反，干预组活检期间的VNS评分更高[3（2至4）. 3（2至3），P = 0.015]。两组术后30分钟时的疼痛评分或满意度评分无显著差异。两组在血尿、尿潴留、感染、血精和血管迷走神经反应等并发症方面无显著差异（P>0.05）。
与传统PNB相比，靶向PNB能显著减轻患者疼痛且不增加并发症发生率。
