Prospective study comparing two methods of anaesthesia for prostate biopsies: apex periprostatic nerve block versus intrarectal XXXX gel: review of the literature.

@entity1 @entity227 @entity3303 @entity158
INTRODUCTION: Studies have demonstrated the need for @entity158 control during multiple transrectal prostate biopsies. Due to encountered published results on periprostatic nerve block, we prospectively evaluated the efficacy and safety of periprostatic local anaesthesia at the apex in comparison to intrarectal @entity3303 gel. METHODS: From January 2001 to January 2002 110 @entity1 underwent prostate biopsy. @entity1 were randomized to receive 10 cc of either 2% @entity3303 gel intrarectally (Group 1) or 10 cc of 1% @entity3303 solution injected under ultrasound guidance for bilateral periprostatic nerve block at the apex (Group 2). @entity158 during biopsy was assessed using a 10-point linear visual analog @entity158 scale and a 5-point digital @entity227 scale (continuous variables). Statistical analysis of @entity158 scores was performed using the Student t-test. RESULTS: 96 @entity1 fitted the inclusion and presented no exclusion criteria. 43 @entity1 composed group 1, and 53 @entity1 group 2. The mean @entity158 score was 2.76+/-1.69 and 1.73+/-1.26 for group 1 and 2, respectively for the 10-point linear visual analog @entity158 scale (p=0.001). The mean @entity158 score was 2.26+/-0.82 and 1.62+/-0.56 for groups 1 and 2, respectively for the 5-point digital @entity227 scale (p<0.001). There was no difference in mean @entity1 age (p=0.348), prostate size (p=0.899), serum PSA (p=0.932), and complications when comparing both groups. The number of biopsies per @entity1 was significantly higher in group 2 (p=0.006), but @entity158 scores in each scale were significantly less. CONCLUSIONS: Periprostatic nerve block at the apex is superior to intrarectal @entity3303 gel for controlling @entity158 during transrectal prostate biopsy, with no increased complications. This technique should be recommended for those @entity1 without anal or rectal inflammatory diseases.
