Sedation as an alternative method to lessen patient discomfort due to transrectal ultrasonography-guided prostate biopsy.
BACKGROUND
Despite being highly efficient for the relief of patient discomfort due to transrectal ultrasound (TRUS) guided prostate biopsy, periprostatic anesthesia is occasionally reported to be of limited use. We aimed to evaluate the efficacy of conscious sedation, an accepted method for lessening patient discomfort due to interventional radiological procedures and compare it with periprostatic anesthesia.


METHODS
93 candidates for biopsy were randomised to three groups: group 1 (n = 31) received intravenous midazolam, group 2 (n = 31) received periprostatic lidocaine injection, whereas group 3 (n = 31) received no anesthetic before the procedure. After the biopsy patients were asked to express discomfort by visual anologue scale (VAS).


RESULTS
The mean scores for groups 1 and 2 were significantly lower than that of group 3 (1.4 +/- 1.1 and 2.0 +/- 1.5 versus 4.7 +/- 1.6, respectively; p < 0.05 for both). For patients with VAS scores exceeding 4 (moderate to severe discomfort), a significant difference was calculated between groups 1 and 2 (3% versus 29%, p < 0.05) and between each and group 3 (3% and 29% versus 80%, respectively; p < 0.05 for each).


CONCLUSIONS
Sedation is an alternative for increasing patient comfort during TRUS-guided prostate biopsy, especially in clinical situations like patient anxiety, young age, repeat biopsies or inflammatory anal diseases.
Turgut
A T
AT
Department of Radiology, Ankara Training and Research Hospital, Ministry of Health, Turkey. ahmettuncayturgut@yahoo.com
Ergun
E
E
Koşar
U
U
Koşar
P
P
Ozcan
A
A
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000779:Anesthetics, Local / Q000008:administration & dosage; D001706:Biopsy / Q000379:methods*; D016009:Chi-Square Distribution; D016292:Procedural Sedation; D004311:Double-Blind Method; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D012007:Rectum; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D008012:Lidocaine; D008874:Midazolam