Periprostatic nerve blockage reduces postoperative analgesic consumption and pain scores of patients undergoing transurethral prostate resection.
BACKGROUND
To evaluate the effects of periprostatic bupivacaine administration on pain control and analgesic consumption after transurethral prostate resection (TURP).


METHODS
The study included 40 male patients with benign prostatic hyperplasia who underwent TURP, and they were divided randomly into two groups. All patients were operated under general anesthesia. The study group patients (n = 20) received periprostatic bupivacaine (0.5% 20 ml) injection (group I), and the control patients (n = 20) received only saline (NaCl 0.9% 20 ml) injection (group II). All injections were performed bilaterally into the periprostatic areas immediately after the TURP procedure via the transperineal route. In the postoperative period, all patients (groups I and II) received tramadol using a patient-controlled analgesia device. Postoperative pain was assessed and recorded using the visual analog scale (VAS) at postoperative hours 1, 2, 3, 4, 5, 6, 7, 8, 12, 16, 20, 24, and 48. Total tramadol consumptions and additional analgesic requirements were also recorded and compared between groups.


RESULTS
There was no difference in demographic data between the two groups (p > 0.05). VAS scores of the patients at hours 1, 3, 4, 5, 7, 8, and 12 were found to be significantly lower in group I than in group II (p < 0.05). Total tramadol consumption and patient-controlled analgesia demands of groups I and II were 153.5 +/- 52.4 vs. 465.0 +/- 55.1 mg and 17.1 +/- 7.7 vs. 77.8 +/- 7.5 mg, respectively (p < 0.001). No side effect was observed regarding bupivacaine injections.


CONCLUSIONS
Periprostatic bupivacaine administration was a useful and safe method for postoperative pain control and reduced analgesic consumption in patients undergoing TURP.
Gorur
Sadik
S
Department of Urology, Mustafa Kemal University, School of Medicine, Antakya/Hatay, Turkey. sadgorur@hotmail.com
Inanoglu
Kerem
K
Akkurt
B Cagla O
BC
Candan
Yasar
Y
Kiper
Ahmet N
AN
D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology / Q000517:prevention & control*; D011336:Probability; D011467:Prostate / Q000187:drug effects / Q000294:innervation; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000601:surgery*; D012016:Reference Values; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
D000779:Anesthetics, Local; D002045:Bupivacaine