Ueda Norichika, Sato Mototaka, Mori Shunsuke, Matsukawa Atsuki, Oki Yuta, Kujime Yuma, Mizuno Ryoya, Horitani Hiromu, Yamamoto Tetsuya, Fukae Shota, Yoshinaga Mitsuhiro, Matsushita Makoto, Akiyama Mai, Kamido Satoshi, Honda Ayako, Nakayama Jiro, Tei Norihide, Miyake Osamu
Department of Urology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan.
Department of Urology, Osaka Rosai Hospital, 1179-3 Nagasanecho, Kita-ku, Sakai, Osaka 591-8025, Japan.
Adv Urol. 2024 Feb 14;2024:9331738. doi: 10.1155/2024/9331738. eCollection 2024.
In Japan, caudal block with 1% lidocaine is commonly used for transrectal prostate biopsy. Although 10 mL of 1% lidocaine is commonly used, the appropriate dosage of 1% lidocaine has not been studied. Our hospital routinely uses two different doses (5 or 10 mL) of 1% lidocaine for caudal block for transrectal prostate biopsy. Herein, we retrospectively evaluated the efficacy and safety of both doses of 1% lidocaine.
This retrospective study included 869 patients who underwent transrectal prostate biopsy with caudal block at our hospital. The amount of 1% lidocaine was determined by the day of the week on which the biopsy was performed, and the patient voluntarily chose the day of the biopsy, unaware of the dose of 1% lidocaine used on that day. Pain, anal sphincter tonus, cancer diagnosis rate, and early complications were compared.
In total, 466 and 403 patients received 5 and 10 mL of 1% lidocaine for a caudal block, respectively. After propensity-score matching for patient characteristics, each group contained 395 patients. The pain score, anal sphincter tonus score, or prostate cancer diagnosis rate were not significantly different between the two groups. However, rectal bleeding was significantly more frequent and severe in the 10-mL than the 5-mL group (=0.018 and =0.0036, respectively). The incidence of other complications was not significantly different between the groups.
Our results suggest that 5 mL of 1% lidocaine may be more suitable than 10 mL for caudal block during transrectal prostate biopsy.
在日本，1%利多卡因的骶管阻滞常用于经直肠前列腺活检。虽然通常使用10毫升1%利多卡因，但1%利多卡因的合适剂量尚未得到研究。我院经直肠前列腺活检的骶管阻滞常规使用两种不同剂量（5或10毫升）的1%利多卡因。在此，我们回顾性评估了两种剂量1%利多卡因的疗效和安全性。
这项回顾性研究纳入了我院869例行骶管阻滞下经直肠前列腺活检的患者。1%利多卡因的用量根据活检进行的星期几确定，患者在不知道当天所用1%利多卡因剂量的情况下自愿选择活检日期。比较疼痛、肛门括约肌张力、癌症诊断率和早期并发症。
共有466例和403例患者分别接受了5毫升和10毫升1%利多卡因的骶管阻滞。在对患者特征进行倾向得分匹配后，每组各有395例患者。两组之间的疼痛评分、肛门括约肌张力评分或前列腺癌诊断率无显著差异。然而，10毫升组的直肠出血明显比5毫升组更频繁、更严重（分别为P = 0.018和P = 0.0036）。两组之间其他并发症的发生率无显著差异。
我们的结果表明，经直肠前列腺活检时，5毫升1%利多卡因可能比10毫升更适合用于骶管阻滞。
