Lack of effect of intrarectal lidocaine for pain control during transrectal prostate biopsy: a randomized prospective study.
OBJECTIVE
Transrectal ultrasound guided biopsy is an essential part in the diagnosis of prostate cancer. Although this procedure is well tolerated by most patients, sometimes it can result in some uneasiness. In this randomised double-blind placebo controlled study, we evaluated the effectiveness of intrarectal lidocaine during TRUS guided biopsy.


METHODS
100 consecutive eligible patients who had elevated total prostate specific antigen (tPSA) and/or abnormal digital rectal examination (DRE) were included into this study. Patients were randomised into two groups. Group I received 20 cc of 2% intrarectal lidocaine 20 minutes before transrectal ultrasound guided biopsy and Group II received same amount of serum physiologic. Pain was assessed using a 10 point modified visual analog scale.


RESULTS
Mean patient age was 65.5+/-2.5 and 64.5+/-11.5 years, mean tPSA was 12.3+/-3.6 and 11.3+/-1.7 ng/ml, mean biopsy duration was 6.8+/-2.5 and 6.6+/-2.2 minutes, mean pain score during transrectal ultrasound guided biopsy was 4.8+/-2.2 and 4.4+/-2.1 in Groups I and II, respectively. No statistically significant difference was observed with respect to age, tPSA, mean biopsy duration and pain score between these groups. There was only one patient who could not tolerate the procedure at all, and he was paradoxically in the lidocaine group.


CONCLUSIONS
The use of intrarectal lidocaine is not superior to placebo during transrectal prostate biopsy for pain control.
Cevik
Ibrahim
I
URO-TIP Health Services-Istanbul, Bagdat cad No 448 Kat 1, 81070 Suadiye-, Istanbul, Turkey.
Ozveri
Hakan
H
Dillioglugil
Ozdal
O
Akdaş
Atif
A
D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001707:Biopsy, Needle / Q000379:methods*; D004311:Double-Blind Method; D006801:Humans; D015552:Injections, Intralesional; D007432:Intraoperative Period; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods
D000779:Anesthetics, Local; D008012:Lidocaine