title: Periprostatic nerve block (PNB) alone vs PNB combined with an anaesthetic-myorelaxant agent cream for prostate biopsy: a prospective, randomized double-arm study.
abstract: OBJECTIVE
  To compare the efficacy of periprostatic nerve block (PNB) alone vs PNB combined with the local administration of a 1.5% lidocaine/0.3% nifedipine cream (Antrolin, Bracco, Milan, Italy).
  
  
  METHODS
  In a prospective, randomized, double-arm study, 200 patients were randomized to receive PNB alone (group A, 100) or PNB combined with a previous administration of the topical anaesthetic Antrolin (group B, 100). The PNB was applied by infiltrating bilaterally a solution of 5 mL lidocaine 1% and naropine 0.75%. Patients were asked to complete visual analogue scale (VAS) questionnaire (0-10) to score pain and discomfort during probe insertion (VAS1), PNB (VAS2), cores (VAS3), 30 min after biopsy (VAS4), the evening of the procedure (VAS5), and the day after biopsy (VAS6).
  
  
  RESULTS
  Pain during probe insertion in group B was significantly less than in group A (VAS1 0.82 vs 2.9; P < 0.001). Pain during periprostatic infiltration was also lower in group B than group A (VAS2 1.4 vs 3.48; P < 0.001). Pain control was similar during biopsy in the two groups (VAS3 1.28 vs 1.2; P = 0.69). The pain scored at VAS4 was significantly less in group B (0.7 vs 1.86, P < 0.001), as was VAS5 (0.68 vs 1.3, P < 0.001). There was no difference in pain perception the day after biopsy (VAS6, 0.32 vs 0.22, P = 0.14).
  
  
  CONCLUSIONS
  Antrolin placed with PNB is better than PNB alone in reducing pain and discomfort during transrectal-ultrasonography guided prostate biopsy.
authors.affiliation: Unit of Urology, Fatebenefratelli Hospital, Naples, Italy. francescocantiello@alice.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Cantiello
authors.forename: Vittorio
authors.initials: V
authors.lastname: Imperatore
authors.forename: Mariateresa
authors.initials: M
authors.lastname: Iannuzzo
authors.forename: Gennaro
authors.initials: G
authors.lastname: Scibelli
authors.forename: Sergio
authors.initials: S
authors.lastname: Di Meo
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Fusco
authors.forename: Ciro
authors.initials: C
authors.lastname: Imbimbo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mirone
mesh_terms: D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001707:Biopsy, Needle / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D004812:Epidemiologic Methods; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage*; D009543:Nifedipine / Q000008:administration & dosage; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D011471:Prostatic Neoplasms / Q000473:pathology*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local; D009467:Neuromuscular Depolarizing Agents; D008012:Lidocaine; D009543:Nifedipine