title: Efficacy of periprostatic local anesthetic for prostate biopsy analgesia: a meta-analysis.
abstract: OBJECTIVE
  To perform a meta-analysis of available randomized trials investigating the analgesic efficacy of periprostatic block with local anesthetic.
  
  
  METHODS
  The National Library of Medicine's PubMed database was searched for the time period 1966 to August 16, 2005 for all relevant articles. Inclusion criteria included subjects undergoing prostate biopsy, trials that were randomized with one arm of the randomization using local anesthetic for periprostatic block before prostate biopsy, and where the assessment of biopsy pain was measured and available in a form compatible for statistical analysis in our meta-analysis.
  
  
  RESULTS
  Our search resulted in 107 abstracts, of which a total of 16 articles met all inclusion criteria. There were 660 subjects who received local anesthetics for a periprostatic block and 616 subjects who did not. The weighted mean difference between the groups indicates that subjects receiving local anesthetic periprostatic block would have a statistically lower pain score compared with those who did not (weighted mean difference in visual analogue pain of -1.66 [95% confidence interval -2.03 to -1.29]).
  
  
  CONCLUSIONS
  Our meta-analysis suggests that periprostatic block with local anesthetic for prostate biopsy might result in significantly lower levels of pain during the biopsy procedure. Because periprostatic block with local anesthetic is relatively easy to administer and does not seem to be associated with increased morbidity, clinicians performing prostate biopsies should consider using this technique on a routine basis.
authors.affiliation: Department of Anesthesiology, The Johns Hopkins University, Baltimore, Maryland 21287, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Richman
authors.forename: H Ballentine
authors.initials: HB
authors.lastname: Carter
authors.forename: Marie N
authors.initials: MN
authors.lastname: Hanna
authors.forename: Jamie D
authors.initials: JD
authors.lastname: Murphy
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Rowlingson
authors.forename: Robert A F
authors.initials: RA
authors.lastname: Andrews
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Wu
mesh_terms: D000698:Analgesia / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D001707:Biopsy, Needle / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009407:Nerve Block; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D011467:Prostate / Q000473:pathology*; D016032:Randomized Controlled Trials as Topic