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Penthrox alone versus Penthrox plus periprostatic infiltration of local analgesia for analgesia in transrectal ultrasound‐guided prostate biopsy
Author(s) -
Huang Sean,
Pepdjonovic Lana,
Konstantatos Alex,
Frydenberg Mark,
Grummet Jeremy
Publication year - 2016
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.12974
Subject(s) - medicine , methoxyflurane , prostate biopsy , biopsy , ultrasound , prostate , analgesic , urology , surgery , anesthesia , radiology , cancer , halothane
Background The objective of this study was to compare pain intensity in patients undergoing transrectal ultrasound ( TRUS )‐guided biopsy of the prostate with P enthrox alone compared with P enthrox plus periprostatic infiltration of local analgesia ( PILA ). Method Seventy‐two subjects participated in this study after receiving appropriate education. Forty‐two patients self‐administered inhaled P enthrox (3 mL methoxyflurane) alone for analgesia ( G roup A ), followed by 30 patients who self‐administered P enthrox and received PILA with 5 mL of 2% lignocaine. All subjects had TRUS biopsy performed. Immediately after the procedure, patients were asked to rate their pain intensity using a numerical verbal rating scale from 0 to 10. Results Baseline characteristics of the two groups were similar. Patients in G roup B reported significantly lower post TRUS biopsy median pain intensity of 2 (1–3) compared with G roup A subjects who reported a median post TRUS biopsy pain intensity of 3 (2–5) ( P = 0.014). A total of 72 men underwent TRUS ‐guided biopsy. All patients indicated they would be happy to have another TRUS ‐guided prostate biopsy in the future. Conclusion Our study shows that P enthrox plus PILA shows promise as an efficacious and easily tolerated analgesic technique for outpatient TRUS biopsy, keeping resource use to a minimum. Planning for a multi‐centre, double‐blind randomized control trial comparing P enthrox plus PILA with PILA alone is presently underway.