Bupivacaine provides rapid, effective periprostatic anaesthesia for transrectal prostate biopsy.
OBJECTIVE
To examine the effectiveness of the longer acting agent bupivacaine in providing periprostatic anaesthesia during transrectal ultrasonography (TRUS)-guided biopsy, as the periprostatic injection of lidocaine has been shown to significantly alleviate the pain of this procedure.


METHODS
Seventy-five patients were randomized to receive a periprostatic injection with either bupivacaine, a lidocaine/bupivacaine (1/1) combination, or no local anaesthesia. Immediately before biopsy 5 mL of the anaesthetic was injected under TRUS guidance into the periprostatic nerves bilaterally. After taking a 10-core biopsy the patients were given a visual analogue scale (VAS; 0-10) to assess their pain during the procedure.


RESULTS
The mean VAS scores were 2.04 in the bupivacaine group and 4.46 in the control (no local anaesthetic) group (P < 0.001).


CONCLUSIONS
Bupivicaine provides significant, immediate periprostatic anaesthesia for TRUS biopsy.
Rabets
J C
JC
Glickman Urological Institute, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Jones
J S
JS
Patel
A R
AR
Zippe
C D
CD
D019162:Anesthetics, Combined; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001707:Biopsy, Needle / Q000379:methods; D002045:Bupivacaine / Q000008:administration & dosage*; D006801:Humans; D015552:Injections, Intralesional; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D011467:Prostate / Q000473:pathology*
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D008012:Lidocaine; D002045:Bupivacaine