IngentaConnect The rectal administration of lignocaine gel and periprostatic lig...

Authors: Siddiqui, E.J.¹; Ali, S.¹; Koneru, S.¹

Source: Annals of The Royal College of Surgeons of England, Volume 88, Number 2, March 2006 , pp. 218-221(4)

Publisher: The Royal College of Surgeons of England

Abstract:

INTRODUCTION: Transrectal ultrasound guided prostate needle biopsy (TRUS) is the standard procedure to diagnose or exclude prostate cancer. This procedure can be associated with significant discomfort, both on insertion of the ultrasound probe as well as on taking the biopsy. We evaluated a new technique for pain relief during TRUS biopsy.

PATIENTS AND METHODS: In Group 1 (n = 60), the biopsies were taken without any analgesia. In Group 2 (n = 60), 11 ml of Instillagel (2% lignocaine) was administered rectally prior to probe insertion and 5 ml of 1% lignocaine periprostatic injection was administered before taking the biopsy. The discomfort encountered during the procedure was graded by the patient on a scale ranging from no discomfort to mild, moderate and severe pain.

RESULTS: In Group 2, there was a marked reduction in the pain experienced during the procedure. The Chi-squared test for trend showed a significant association between the rectal administration of local anaesthetic gel and reduction in pain on probe insertion (P = 0.0001). There was also a significant association between the use of periprostatic lignocaine injection and reduction in pain on taking the biopsy (P < 0.0001).

CONCLUSIONS: The use of lignocaine gel prior to probe insertion and periprostatic infiltration of lignocaine before taking the needle biopsy significantly reduces the pain experienced by the patient during TRUS-guided prostate biopsy.

Keywords: PROSTATE; TRANSRECTAL ULTRASOUND; BIOPSY; PERIPROSTATIC INFILTRATION

Document Type: Research article

DOI: 10.1308/003588406X95048

Affiliations: 1: Department of Urology, Manor Hospital, Walsall, UK

The rectal administration of lignocaine gel and periprostatic lignocaine infiltration during transrectal ultrasound-guided prostate biopsy provides effective analgesia