Tramadol improves patients' tolerance of transrectal ultrasound-guided prostate biopsy.
OBJECTIVE
To evaluate the analgesic advantage of tramadol in patients undergoing transrectal biopsy of the prostate in ambulatory settings compared with topical analgesia.


METHODS
A total of 77 patients scheduled for prostate biopsy were randomly assigned to receive 5% lidocaine ointment 5 mL per rectum 10 minutes before the procedure (group 1) or lidocaine ointment combined with tramadol drops 1 mg/kg per os 40 minutes before the procedure (group 2). Pain severity, main cardiorespiratory parameters, difficulty of the procedure, procedure-related side effects, and complications were analyzed.


RESULTS
No significant respiratory or hemodynamic disturbances were observed. The pain severity, as measured on a visual analog scale, was significantly lower in group 2 (P = 0.038), and the rate of overall satisfaction with the level of analgesia was significantly greater (P = 0.027). The urologist's assessment of "very easy" was assigned to 77.1% of procedures in group 2 compared with 54.8% of procedures in group 1 (P = 0.04). The rate of side effects in both groups was similar at 9.5% versus 11.4% (P = 0.785).


CONCLUSIONS
The combination of lidocaine per rectum with tramadol per os is a simple and safe technique providing good analgesic effect and, therefore, can be recommended for transrectal ultrasound-guided prostate biopsy.
Hirsh
Irina
I
Department of Anesthesiology and Critical Care Medicine, Lady Davis Carmel Medical Center and B. & R. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. hi767682@yahoo.com
Kaploun
Alexander
A
Faris
Gazy
G
Appel
Boaz
B
Shneider
Ilia
I
Stein
Avi
A
Pizov
Reuven
R
D000284:Administration, Oral; D000285:Administration, Rectal; D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001707:Biopsy, Needle / Q000379:methods; D004311:Double-Blind Method; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D014147:Tramadol / Q000009:adverse effects / Q000627:therapeutic use*; D014463:Ultrasonography; D036761:Ultrasound, High-Intensity Focused, Transrectal
D000701:Analgesics, Opioid; D014147:Tramadol; D008012:Lidocaine