Lidocaine suppositories for prostate biopsy.
OBJECTIVE
To evaluate, in a randomized prospective study, the efficiency of transrectal lidocaine suppositories to reduce pain during transrectal prostate biopsy, as suppositories allow longer for the agent to be effective.


METHODS
In all, 100 patients were randomized to receive either a placebo suppository or 10 mL of 2% (200 mg) lidocaine gel rectally 10 min before biopsy, or a suppository containing 60 mg lidocaine 1 or 2 h before biopsy. Costs (in euros) per application were 0.82 for gel and 0.63 for suppositories. In all patients the same 10-core biopsy technique was used. Pain was evaluated using a visual linear pain scale ranging from 0 to 100 points; the patient's side of the scale did not show the number of points.


RESULTS
The mean pain scores in the placebo, lidocaine gel, and lidocaine suppositories applied 1 h and 2 h before biopsy were 36.2, 40.9, 29.2 and 21.2, respectively. Thus patients with no anaesthesia reported 25% more pain than those receiving lidocaine suppositories 1 h before and 71% more pain than those receiving lidocaine suppositories 2 h before biopsy (P = 0.002).


CONCLUSIONS
Lidocaine suppositories at a lower dose and with longer to take effect can be used to reduce pain significantly more effectively than the commonly used gel. As suppositories are easy to use and cheap, they are recommended in daily routine prostate biopsy.
Fink
Klaus G
KG
Urology, Salzburger Landeskliniken, Paracelsus Private Medical University, Salzburg, Austria. k.g.fink@salk.at
Gnad
Andrea
A
Meissner
Phillip
P
Götschl
Robert
R
Schmeller
Nikolaus T
NT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics; D001706:Biopsy / Q000191:economics / Q000379:methods; D003365:Costs and Cost Analysis; D005782:Gels / Q000191:economics; D006801:Humans; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D013488:Suppositories / Q000191:economics
D000700:Analgesics; D005782:Gels; D013488:Suppositories; D008012:Lidocaine