Ouzounidis X, Moysidis K, Kalinderis N, Papanikolaou D, Koukourikis P, Papaefstathiou E, Hatzimouratidis K
2nd Urology Department of Medical Faculty, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Hippokratia. 2020 Oct-Dec;24(4):166-172.
Recent evidence suggests that additional analgesic regimens to periprostatic nerve block (PPNB) anesthesia provide substantial pain relief during transrectal ultrasound-guided prostate biopsy. In this regard, we investigated the efficacy and safety of tramadol alone or in combination with parecoxib as adjunct regimens to PPNB anesthesia.
A total of 51 participants were randomly allocated into three study groups: Group 1 received PPNB anesthesia, Group 2 received tramadol and PPNB anesthesia, whereas Group 3 received both tramadol and parecoxib as adjunct regimens to PPNB anesthesia. The pain was evaluated at three different time points during biopsy: at the time of probe insertion (NRS1), at the time of PPNB anesthesia (NRS2), and at the time of the actual biopsy itself (NRS3), using a numeric rating scale (NRS) of pain. Safety was evaluated by the occurrence of complications and adverse effects.
The mean NRS1 score was statistically significantly different in Groups 2 and 3 than in Group 1 (2.4 ± 1.3 and 1.1 ± 1.2 vs. 4.5 ± 1.8; p <0.0167). We found a statistically significant difference regarding NRS 2 score in Groups 2 and 3 than in Group 1 (2.6 ± 1.4 and 1.1 ± 1.3 vs. 4.1 ± 1.3; p <0.0167). The mean NRS1 and NRS2 scores were found to be statistically significantly different in Group 3 than in Group 2 (1.1 ± 1.2 vs. 2.4 ± 1.3 as well as 1.1 ± 1.3 vs. 2.6 ± 1.4; p <0.0167). Also, a statistically significant difference was found between Groups 2 and 3 regarding hematuria episodes [0 (0.0) vs. 5 (29.4); p <0.0167].
Tramadol as an adjunct regimen to PPNB anesthesia is a safe and straightforward technique that provides a significant analgesic effect. The effectiveness is even higher when tramadol is combined with parecoxib. HIPPOKRATIA 2020, 24(4): 166-172.
最近的证据表明，除前列腺周围神经阻滞（PPNB）麻醉外，其他镇痛方案在经直肠超声引导下前列腺活检期间可提供显著的疼痛缓解。在这方面，我们研究了曲马多单独使用或与帕瑞昔布联合使用作为PPNB麻醉辅助方案的疗效和安全性。
总共51名参与者被随机分为三个研究组：第1组接受PPNB麻醉，第2组接受曲马多和PPNB麻醉，而第3组接受曲马多和帕瑞昔布作为PPNB麻醉的辅助方案。在活检期间的三个不同时间点评估疼痛：探头插入时（NRS1）、PPNB麻醉时（NRS2）以及实际活检时（NRS3），使用疼痛数字评定量表（NRS）。通过并发症和不良反应的发生情况评估安全性。
第2组和第3组的平均NRS1评分与第1组相比有统计学显著差异（2.4±１.3和1.1±1.2 vs. 4.5±1.8；p<0.0167）。我们发现第2组和第3组的NRS2评分与第1组相比有统计学显著差异（2.6±1.4和1.1±1.3 vs. 4.1±1.3；p<0.0167）。发现第3组的平均NRS1和NRS2评分与第2组相比有统计学显著差异（1.1±1.2 vs. 2.4±1.3以及1.1±1.3 vs. 2.6±1.4；p<0.0167）。此外，第2组和第3组在血尿发作方面也有统计学显著差异[0（0.0）vs. 5（29.4）；p<0.0167]。
曲马多作为PPNB麻醉的辅助方案是一种安全且简单的技术，可提供显著的镇痛效果。当曲马多与帕瑞昔布联合使用时，效果更佳。《希波克拉底》2020年，24(4)：166 - 172。
