title: Comparison of lidocaine suppositories and periprostatic nerve block during transrectal prostate biopsy.
abstract: The aim of this randomized prospective and partially double-blind study was to evaluate the efficacy of transrectal lidocaine applied as suppositories in comparison to periprostatic infiltration as methods of reducing pain during transrectal prostate biopsy. 100 patients were randomized to four groups and received either a suppository containing 60 mg of lidocaine 2 h before biopsy, a 120-mg lidocaine suppository 1 h before biopsy, a 120-mg lidocaine suppository 2 h before biopsy, or they were anaesthetized with a periprostatic infiltration of 5 ml 2% lidocaine. In all patients the same 10-core transrectal biopsy technique was performed. Pain was evaluated using a visual pain scale ranging from 0 to 10 points. The mean pain score in the 60-mg (2 h), 120-mg (1 h), and 120-mg (2 h) lidocaine suppository groups was 3.63, 3.56, and 3.58 respectively. The mean pain score of patients receiving periprostatic infiltration was 1.80. No patient showed vegetative symptoms like sweating or hypotonia. No patient had severe pain. Eight of the 9 patients with no pain were in the periprostatic injection group. Thus, all lidocaine suppositories showed a good analgesic effect although a significantly better pain reduction was achieved by periprostatic lidocaine infiltration.
authors.affiliation: Department of Urology and Andrology, Paracelsus Medizinische Privatuniversitat, Landeskliniken Salzburg, Salzburg, Austria. r.szlauer@salk.at
authors.forename: Roman
authors.initials: R
authors.lastname: Szlauer
authors.forename: Robert
authors.initials: R
authors.lastname: Gotschl
authors.forename: Andrea
authors.initials: A
authors.lastname: Gnad
authors.forename: Phillip
authors.initials: P
authors.lastname: Meissner
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Paras
authors.forename: Nikolaus T
authors.initials: NT
authors.lastname: Schmeller
authors.forename: Klaus G
authors.initials: KG
authors.lastname: Fink
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D001706:Biopsy / Q000009:adverse effects; D004311:Double-Blind Method; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D009407:Nerve Block / Q000379:methods; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D011467:Prostate / Q000294:innervation / Q000473:pathology*; D013488:Suppositories
chemical_list: D000779:Anesthetics, Local; D013488:Suppositories; D008012:Lidocaine