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Periprostatic nerve block (PNB) alone vs PNB combined with an anaesthetic‐myorelaxant agent cream for prostate biopsy: a prospective, randomized double‐arm study
Author(s) -
Cantiello Francesco,
Imperatore Vittorio,
Iannuzzo Mariateresa,
Scibelli Gennaro,
Di Meo Sergio,
Fusco Ferdinando,
Imbimbo Ciro,
Mirone Vincenzo
Publication year - 2009
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2008.08198.x
Subject(s) - medicine , lidocaine , biopsy , nerve block , visual analogue scale , anesthesia , randomized controlled trial , surgery , prospective cohort study , prostate biopsy , prostate , cancer
OBJECTIVE To compare the efficacy of periprostatic nerve block (PNB) alone vs PNB combined with the local administration of a 1.5% lidocaine/0.3% nifedipine cream (Antrolin®, Bracco, Milan, Italy). PATIENTS AND METHODS In a prospective, randomized, double‐arm study, 200 patients were randomized to receive PNB alone (group A, 100) or PNB combined with a previous administration of the topical anaesthetic Antrolin (group B, 100). The PNB was applied by infiltrating bilaterally a solution of 5 mL lidocaine 1% and naropine 0.75%. Patients were asked to complete visual analogue scale (VAS) questionnaire (0–10) to score pain and discomfort during probe insertion (VAS1), PNB (VAS2), cores (VAS3), 30 min after biopsy (VAS4), the evening of the procedure (VAS5), and the day after biopsy (VAS6). RESULTS Pain during probe insertion in group B was significantly less than in group A (VAS1 0.82 vs 2.9; P < 0.001). Pain during periprostatic infiltration was also lower in group B than group A (VAS2 1.4 vs 3.48; P < 0.001). Pain control was similar during biopsy in the two groups (VAS3 1.28 vs 1.2; P = 0.69). The pain scored at VAS4 was significantly less in group B (0.7 vs 1.86, P < 0.001), as was VAS5 (0.68 vs 1.3, P < 0.001). There was no difference in pain perception the day after biopsy (VAS6, 0.32 vs 0.22, P = 0.14). CONCLUSIONS Antrolin placed with PNB is better than PNB alone in reducing pain and discomfort during transrectal‐ultrasonography guided prostate biopsy.