title: Transrectal ultrasound (TRUS) guided prostate biopsy: Three different types of local anesthesia.
abstract: Transrectal Ultrasound (TRUS) guided prostate biopsy is regarded as the gold standard for prostate cancer diagnosis. The majority of patients perceive TRUS-guided prostate biopsy as a physically and psychologically traumatic experience. We aimed to compare in this paper the efficacy of three different anesthesia techniques to control the pain during the procedure.
  
  
  METHODS
  150 patients who underwent transrectal ultrasound (TRUS) guided prostate biopsy were randomly divided into three groups. Group A included 50 patients who received one hour before the procedure a mixture of 2.5% lidocaine and 2.5% prilocaine, Group B: 50 patients who received intrarectal local anesthetic administration (lidocaine 5 ml 10%) and lidocaine local spray 15 % and Group C included 50 patients who received periprostatic block anesthesia (lidocaine 10 ml 10%). Visual analogue scale (VAS) of patients in different groups was evaluated at the end of the biopsy and 30 minutes after the procedure.
  
  
  RESULTS
  The VAS of patients in Group A was 1.32 ± 0.65 (VAS I) and 2.47 ± 0.80 (VAS II). In group B the VAS of patients was 1.09 ± 0.47 (VAS I) and 1.65 ± 0.61 (VAS II). In group C the VAS of patients was 2.63 ± 0.78 (VAS I) and 1.70 ± 0.85 (VAS II). There was no statistically significant difference in term of VAS I between group A and B. A statistically significant difference was determined in terms of VAS II between group A and B. There was no statistically significant difference in term of VAS between group B and C.
  
  
  CONCLUSIONS
  The most effective of the three methods for pain control we used was intrarectal local anesthetic administration and lidocaine local spray 15% that enables an ideal patient comfort.
authors.affiliation: Unit of Urology, Department of Human Pathology, University of Messina, Messina,. cmagno@unime.it.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Anastasi
authors.forename: Enrica
authors.initials: E
authors.lastname: Subba
authors.forename: Rosa
authors.initials: R
authors.lastname: Pappalardo
authors.forename: Luciano
authors.initials: L
authors.lastname: Macchione
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Ricotta
authors.forename: Graziella
authors.initials: G
authors.lastname: Muscarà
authors.forename: Francesco
authors.initials: F
authors.lastname: Lembo
authors.forename: Carlo
authors.initials: C
authors.lastname: Magno
mesh_terms: D000368:Aged; D000772:Anesthesia, Local / Q000145:classification*; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D018084:Ultrasonography, Interventional