[Utility of local anesthesia of the periprostatic plexus in the control of the pain in the ultrasound-guided prostate biopsy].
OBJECTIVE
Periprostatic plexus anesthesia (PPA) is not current practice during prostate ultrasound-guided biopsy (PB). Many patients must undergo a second or more PB if a prostate carcinoma is suspected. Due to pain, many patients reject the procedure, or it has to be performed with general anesthesia. Our objective was to evaluate the utility of PPA to eliminate the pain caused by PB, as well as the acceptance of the procedure under these conditions.


METHODS
Between october 2002 and june 2003 we designed a randomized prospective study with 275 patients that were seen in 2 different hospitals and required PB. In the 1st group we included 101 males who underwent PB without PA. In the other group, 174 male patients submitted PB after PPA were included. 10 cc lidocaine, 2% diluted 50% was injected with a 22g needle. At the end of the procedure, patients were asked to fill in a questionnaire about their satisfaction and degree of pain felt.


RESULTS
In the second group of patients we obtained significantly inferior values (p < 0.005, IC 95%) in the quantitative evaluation of pain compared with the first group (1.24 +/- 0.4 vs. 2.5 +/- 1.1). Ask per the possibility of repeating PB if it were necessary, none of the patients in the 2nd group would object, whereas 10% in the 1st group would not have the biopsy repeated or would only accept it if it was done with general anesthesia. No complications due to PPA were found.


CONCLUSIONS
PPA is a safe procedure that significantly reduces pain during PB, improving its acquiescence among patients.
Cervera Deval
J
J
Fundación Instituto Valenciano de Oncología, Valencia. jcervera@telefonica.net
González Añón
M
M
Martín Díez
F
F
Jornet Fayos
J
J
Morales Olaya
F J
FJ
Selfa Moreno
S
S
D000368:Aged; D000772:Anesthesia, Local; D001706:Biopsy / Q000009:adverse effects; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging* / Q000294:innervation / Q000473:pathology*; D011795:Surveys and Questionnaires; D014463:Ultrasonography