Transrectal ultrasound-guided prostatic biopsy: midazolam, the ideal analgesic.
OBJECTIVE
Patients with raised serum prostate-specific antigen and/or an abnormal-feeling prostate were subjected to transrectal ultrasound-guided prostatic biopsy to rule out any prostatic malignancy. There are many methods for pain relief and to treat discomfort during the procedure but we compared the efficacy of intravenous (IV) midazolam for pain control.


METHODS
This was a prospective study of 50 patients. All patients underwent a ten quadrant biopsy. The patients were divided into two groups: group 1 (study group) which included 25 patients who used 1 ml of IV midazolam and group 2 (control group) which included 25 patients who did not use IV midazolam.


RESULTS
In group 1, of 25 patients only 1 patient had mild pain (VAS 2) during and after the procedure. In group 2, of 25 patients, 15 patients had pain during the procedure.


CONCLUSIONS
Midazolam is a benzodiazepine derivative with an anxiolytic, sedative, amnestic and hypnotic action. Our study shows that using midazolam is a very simple technique which gives excellent analgesia and no other analgesia was required. No monitoring was needed, there was a very low incidence of complications and it did not require any technical expertise.
Shrimali
Pritesh
P
P.D. Hinduja National Hospital, Mumbai, India. prits_2121@yahoo.co.in
Bhandari
Yogesh
Y
Kharbanda
Sushil
S
Patil
Mangesh
M
Srinivas
Vardachary
V
Gaitonde
Satish
S
Mankeshwar
Ranjit
R
D000698:Analgesia; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D001706:Biopsy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography
D018686:Anesthetics, Intravenous; D008874:Midazolam