title: [TRUS-guided biopsy: comparison of two anesthetic methods].
abstract: OBJECTIVE
  The aim of the present study is to compare two analgesic techniques for ultrasound transrectal biopsy. Oral analgesia vs periprosthetic nerve blockade with 2% mevicaine.
  
  
  METHODS
  A total of 200 patients were randomized prospectively into 2 groups, namely group I: 100 patients treated with metamizol, oral morphine 30 minutes before the procedure, and group II: 100 patients anesthesied with periprosthetic nerve blockade with 2% mepivacaine. Both groups were treated with bromacepán 3 mg 30 minutes before the biopsy. The first intention was to obtain 10 core TRUS-guided biopsy in all patients underwent. After the procedure, a ten visual analogue pain score (VAS) from 0 = no discomfort to 10 = severe pain was administered to the biopsied patients and a global estimation of pain associated with the procedure was obtained. Test T de Student was used for statistical analysis.
  
  
  RESULTS
  There were no significant differences in age, PSA and prostate volume. 3 core TRUS-guided biopsy were obtain in group I (3 +/- 1.3), and 10 in group II (5 +/- 1.2) In the periprosthetic block group (II) 95% of patients referred no pain after the procedure (VAS = 0), 2% middle pain (VAS = 5-6) and 3% strong pain (VAS = 7-8); while patients in group I referred 12.5% no pain, 42.4% middle pain, 20% strong pain. The level of pain reported by this group of patients was significantly different from those reported by patients who performed prostate biopsy with periprosthetic nerve blockade. (p < or = 0.05). There were no significant differences in major complications.
  
  
  CONCLUSIONS
  The use of bilateral periprosthetic block with mepivacaine is a very effective and useful technique, well tolerated by the patient, which almost completely abolishes the pain and discomfort associated with the prostate biopsy procedure. And also allows increase the number of cores.
authors.affiliation: Servicio de Urología, Hospital Río Hortega, Valladolid. ccondere@hotmail.com
authors.forename: C
authors.initials: C
authors.lastname: Conde Redondo
authors.forename: D
authors.initials: D
authors.lastname: Alonso Fernández
authors.forename: A
authors.initials: A
authors.lastname: Robles Samaniego
authors.forename: N
authors.initials: N
authors.lastname: Del Valle González
authors.forename: F
authors.initials: F
authors.lastname: Castroviejo Royo
authors.forename: C
authors.initials: C
authors.lastname: Delgado Marcos
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez Toves
authors.forename: J M
authors.initials: JM
authors.lastname: Martínez-Sagarra Oceja
mesh_terms: D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000379:methods*; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D012007:Rectum; D014463:Ultrasonography