title: Local anesthesia for prostate biopsy by periprostatic lidocaine injection: a double-blind placebo controlled study.
abstract: OBJECTIVE
  We determined the efficacy of anesthesia for prostate biopsy by periprostatic lidocaine injection.
  
  
  METHODS
  A total of 90 consecutive patients undergoing prostate biopsies were randomized into lidocaine and placebo groups of 45 each in double-blind fashion. A 5 ml. dose of 1% lidocaine or 0.9% sodium chloride was injected via 23 gauge needles inserted through the transrectal ultrasound probe working channel and aimed at the prostatic neurovascular bundles bilaterally. Patients completed a symptom questionnaire applying a visual analog scale of 0-none to 10-maximal addressing pre-procedure anxiety, overall pain and discomfort throughout the procedure, pain during biopsy punctures and patient tolerance, as judged by the operator. Student's t test was used to analyze continuous variables and the chi-square test was applied for categorical data. Linear regression was done to determine intervariable influences.
  
  
  RESULTS
  The average pain level throughout the procedure was 3.06 in the lidocaine group versus 4.15 in the control group (p = 0.04), while the pain level during biopsy punctures was 1.51 versus 3.98 (p = 0.0001) and patient tolerance was 1.06 versus 1.93 (p = 0.018). The level of discomfort throughout the procedure was lower in the lidocaine group with borderline significance (4.31 versus 5.24, p = 0.077). The lidocaine and control groups were comparable regarding average patient age (65 and 66 years, respectively). Prostate volume was similar in the 2 groups (68.5 versus 63 ml.). The median number of biopsy punctures was 7 and 8, respectively. Cancer was identified in 10 patients (22.2%) per group.
  
  
  CONCLUSIONS
  Periprostatic lidocaine injection is an effective method of anesthesia for prostate biopsy.
authors.affiliation: Departments of Urology and Oncology, Assaf-Harofeh Medical Center, Zerifin, Israel.
authors.forename: Dan
authors.initials: D
authors.lastname: Leibovici
authors.forename: Amnon
authors.initials: A
authors.lastname: Zisman
authors.forename: Yoram I
authors.initials: YI
authors.lastname: Siegel
authors.forename: Avishay
authors.initials: A
authors.lastname: Sella
authors.forename: Judy
authors.initials: J
authors.lastname: Kleinmann
authors.forename: Arie
authors.initials: A
authors.lastname: Lindner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001707:Biopsy, Needle; D004311:Double-Blind Method; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D011467:Prostate / Q000473:pathology*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine