Periprostatic administration of local anesthesia during transrectal ultrasound-guided biopsy of the prostate: a randomized, double-blind, placebo-controlled study.
OBJECTIVE
To evaluate the effect of periprostatic infiltration with local anesthesia on the level of discomfort associated with transrectal ultrasound-guided needle biopsy of the prostate. Transrectal ultrasound-guided needle biopsy of the prostate is the standard procedure to diagnose prostate cancer.


METHODS
A prospective, randomized, double-blind study was performed on 100 men referred for biopsy of the prostate. Fifty subjects were randomized to periprostatic injection of 10 mL of 2% lidocaine solution without epinephrine, and 50 were randomized to injection of placebo (10 mL of 0.9% NaCl). Each subject completed three 10-point visual analog scales for pain after a series of 15 needle biopsies. Pain was rated during the biopsy, diagnostic investigation, and injection of lidocaine.


RESULTS
Patients who received local anesthesia had significantly lower visual analog scale scores compared with the group without lidocaine during the biopsy (mean score 0.76 versus 3.62, P <0.001) and diagnostic examination (mean score 1.08 versus 1.86, P = 0.025). Lidocaine injection caused no adverse effects.


CONCLUSIONS
Periprostatic injection of lidocaine represents a simple and safe procedure that significantly reduces discomfort during probe manipulation and biopsy. We recommend this procedure in men undergoing transrectal ultrasound-guided prostate biopsy.
Berger
Andreas P
AP
Department of Urology, University of Innsbruck, Innsbruck, Austria.
Frauscher
Ferdinand
F
Halpern
Ethan J
EJ
Spranger
Robert
R
Steiner
Hannes
H
Bartsch
Georg
G
Horninger
Wolfgang
W
D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D001707:Biopsy, Needle / Q000379:methods*; D004311:Double-Blind Method; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D010919:Placebos; D011467:Prostate / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D012007:Rectum; D014463:Ultrasonography
D000779:Anesthetics, Local; D010919:Placebos; D008012:Lidocaine