Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea.
BMC Urol. 2021 Sep 16;21(1):132. doi: 10.1186/s12894-021-00898-1.
We identified pain variation according to prostate biopsy sites and compared differences in pain relief according to the site of periprostatic nerve block (PNB).
This retrospective study collected data from 312 patients who underwent transrectal prostate biopsies between January 2019 and August 2020. Patients were stratified into two groups according to the site of local anesthesia (base vs. base and apex PNB), with each block achieved with 2.5 cm of 2% lidocaine. Pain scores were assessed using the visual analog scale at the following time points: probe insertion, PNB at base, PNB at apex, each of the 12 core biopsy sites, and 15 min after biopsy. The results were analyzed using a linear mixed model.
The average pain scores were significantly higher in the base-only PNB group than were those in the base and apex PNB group (3.88 vs 2.82, p < 0.001). In the base-only PNB group, the pain scores increased from base to apex (p < 0.001), and the pain at each site also gradually increased as the biopsy proceeded (p < 0.001). In contrast, in the base and apex PNB group, there was minor change in pain scores throughout the procedure.
The pain scores varied at each site during the prostate biopsy. The provision of a base and apex PNB provided greater pain relief than does base-only PNB during prostate biopsy.
我们根据前列腺活检部位确定疼痛变化，并比较了经直肠前列腺活检时不同部位前列腺周围神经阻滞（PNB）的止痛效果差异。
本回顾性研究收集了 2019 年 1 月至 2020 年 8 月期间接受经直肠前列腺活检的 312 例患者的数据。患者根据局部麻醉部位（仅基底 vs. 基底和尖部 PNB）分为两组，每个阻滞点均采用 2.5 cm 2%利多卡因。在以下时间点使用视觉模拟评分法评估疼痛评分：探针插入时、基底 PNB 时、尖部 PNB 时、12 个核心活检部位中的每一个部位以及活检后 15 分钟。结果采用线性混合模型进行分析。
仅基底 PNB 组的平均疼痛评分明显高于基底和尖部 PNB 组（3.88 vs. 2.82，p<0.001）。在仅基底 PNB 组中，疼痛评分从基底到尖部逐渐增加（p<0.001），随着活检的进行，每个部位的疼痛也逐渐增加（p<0.001）。相比之下，在基底和尖部 PNB 组中，整个过程中疼痛评分变化不大。
前列腺活检过程中每个部位的疼痛评分都有所不同。与仅基底 PNB 相比，基底和尖部 PNB 可提供更好的前列腺活检止痛效果。
