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P enthrox inhaler analgesia in transrectal ultrasound‐guided prostate biopsy
Author(s) -
Lee Chanyang,
Woo Henry H.
Publication year - 2015
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12694
Subject(s) - medicine , methoxyflurane , inhaler , biopsy , visual analogue scale , ultrasound , prostate biopsy , pain relief , anesthesia , prostate , surgery , radiology , asthma , cancer , halothane
Abstract Background Periprostatic injection of local anaesthetic ( PILA ) has been shown to significantly reduce pain in patients undergoing transrectal ultrasound‐guided prostate biopsy ( TRUSPB ). However, this method does not address pain that is associated with ultrasound probe insertion, and the injection of local anaesthetic itself causes pain. The aim of this study was to explore the efficacy of methoxyflurane delivered by a P enthrox inhaler as a novel method of pain relief during TRUSPB . Method From J uly 2012 to J uly 2013, 64 patients were scheduled at a single centre to undergo TRUSPB while receiving analgesia via P enthrox inhaler. Fifteen minutes after the biopsy procedure, these patients were asked to complete a pain score survey using a 10‐cm visual analogue scale ( VAS ) to separately report the degree of pain experienced during digital rectal examination ( DRE ), ultrasound probe insertion and core biopsy. Results The median pain scores on a 10‐cm VAS were 2.0, 2.4 and 3.0 during DRE , probe insertion and needle biopsy, respectively, while using the P enthrox inhaler. Of the 64 patients, 11 had undergone TRUSPB previously receiving PILA . In these patients, PILA was significantly better than the P enthrox inhaler for pain relief during needle biopsy (median pain score 2.0 versus 4.0; P = 0.012). Conclusion The P enthrox inhaler appears to be a safe and effective method of analgesia for TRUSPB . Patients who had experienced both PILA and P enthrox reported pain scores that significantly favoured PILA over the P enthrox inhaler.