title: Transrectal ultrasonography (TRUS)-guided pelvic plexus block to reduce pain during prostate biopsy: a randomised controlled trial.
abstract: OBJECTIVE
  To assess the role of pelvic plexus block (PPB) in reducing pain during transrectal ultrasonography(TRUS)-guided prostate biopsy, compared with the conventional periprostatic nerve block (PNB).
  
  
  METHODS
  A prospective, double-blind observational study was conducted with patients being randomised into three groups. Group-1 (47 patients) received intrarectal local anaesthesia (IRLA) with 10 mL 2% lignocaine jelly along with pelvic plexus block (PPB) with 2.5 mL 2% lignocaine injection bilaterally. Group-2 (46 patients) received IRLA with periprostatic nerve block (PNB). Group-3 (46 patients) received only IRLA without any type of nerve block. The patients were requested to rate the level of pain from 0 to 10 on a visual analogue scale (VAS) at two time points: VAS-1: during biopsy procedure and VAS-2: 30 min after the procedure.
  
  
  RESULTS
  The mean age of the patients, mean volume of the prostates and mean serum PSA values were comparable among the three groups. The mean pain score during biopsy was significantly less in the PPB group [mean (range) sore of 2.91 (2-4)] compared with the PNB group [mean (range) score of 4 (3-5)], and both these groups were superior to the no nerve block group [mean score of 5.4 (3-7)]. There was no significant difference between the mean pain scores, 30 min after the procedure among the three groups with the mean (range) scores being 2.75 (2-4), 2.83 (2-4) and 2.85 (2-4), respectively.
  
  
  CONCLUSIONS
  PPB is superior to conventional periprostatic nerve block (PNB) for pain control during TRUS-guided biopsy and both are in turn superior to no nerve block.
authors.affiliation: Department of Urology, Apollo Gleneagles Hospital, Kolkata, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Jindal
authors.affiliation: Calcutta National Medical College, Kolkata, India.
authors.forename: Subhabrata
authors.initials: S
authors.lastname: Mukherjee
authors.affiliation: Calcutta National Medical College, Kolkata, India.
authors.forename: Rajan K
authors.initials: RK
authors.lastname: Sinha
authors.affiliation: Calcutta National Medical College, Kolkata, India.
authors.forename: Mir R
authors.initials: MR
authors.lastname: Kamal
authors.affiliation: Calcutta National Medical College, Kolkata, India.
authors.forename: Nabankur
authors.initials: N
authors.lastname: Ghosh
authors.affiliation: Calcutta National Medical College, Kolkata, India.
authors.forename: Barun
authors.initials: B
authors.lastname: Saha
authors.affiliation: Calcutta National Medical College, Kolkata, India.
authors.forename: Nilanjan
authors.initials: N
authors.lastname: Mitra
authors.affiliation: Calcutta National Medical College, Kolkata, India.
authors.forename: Pramod K
authors.initials: PK
authors.lastname: Sharma
authors.affiliation: Calcutta National Medical College, Kolkata, India.
authors.forename: Soumendra N
authors.initials: SN
authors.lastname: Mandal
authors.affiliation: Calcutta National Medical College, Kolkata, India.
authors.forename: Dilip
authors.initials: D
authors.lastname: Karmakar
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D000779:Anesthetics, Local / Q000008:administration & dosage; D001706:Biopsy / Q000009:adverse effects / Q000379:methods; D004311:Double-Blind Method; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods; D059408:Pain Management / Q000009:adverse effects / Q000379:methods; D010147:Pain Measurement; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D018084:Ultrasonography, Interventional / Q000379:methods
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine
keywords: biopsy; nerve block; pain; prostate