Local anesthesia with block of the sexual nerve in conduction of transperineal biopsy of the prostate


Cite item

Full Text

Abstract

We studied 137 males (mean age 68 ± 8.6 years) with suspected prostatic cancer who had undergone transperineal biopsy of the prostate (12 tissue samples). The biopsy was made under local anesthesia either as paraprostatic block (n = 76, group 1) or paraprostatic block in combination with block of the sexual nerve (n = 61, group 2). Pain intensity was evaluated with visual analogue scales. Induction of anesthesia was more painful in group 2, three other stages - in group 1. Mean pain at biopsy was significantly (p < 0.001) lower in group 2. Thus, addition of sexual nerve blockade to standard paraprostatic block increases efficacy of anesthesia in conduction of transperitoneal biopsy of the prostate.

References

  1. Crawford E. D. Epidemiology of prostate cancer. Urology 2003; 62: 3-12.
  2. Zeigler-Johnson C. M., Rennert H., Mittal R. D. et al. Evaluation of prostate cancer characteristics in four populations worldwide. Can. J. Urol. 2008; 15: 4056-4064.
  3. Barringer B. S. Carcinoma of the prostate. Surg. Gynecol. Obstetr. 1922; 34: 168-176.
  4. Galfano A., Novara G., Iafrate M. et al. Prostate biopsy: te transperineal approach. EAU-EBU Update Ser. 2007; 5: 241- 249.
  5. Rodriguez A., Kyriakou G., Leray E. et al. Prospective study comparing two methods of anaesthesia for prostate biopsies: apex periprostatic nerve block versus intrarectal lidocaine gel: review of the literature. Eur. Urol. 2003; 44: 195-200.
  6. Autorino R., De Sio M., Di Lorenzo G. et al. How to decrease pain during transrectal ultrasound guided prostate biopsy: a look at the literature. J. Urol. (Baltimore) 2005; 174: 2091-2097.
  7. Buckley M. R., Bryant N. J., Brown J. A. et al. Tolerance of local anesthetic for transrectal ultrasound-guided prostate biopsy: our experience and a literature review. Can. Assoc. Radiol. J. 2006; 57: 169-174.
  8. Inal G., Adsan O., Ugurlu O. et al. Comparison of four different anesthesia methods for relief of all pain during transrectal ultrasound-guided prostate biopsy. Int. Urol. Nephrol. 2008; 40: 335-339.
  9. Jensen P. M., Karoly P., Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain 1986; 27: 117-126.
  10. Schostak M., Christoph F., Muller M. et al. Optimizing local anesthesia during 10-core biopsy of the prostate. Urology 2002; 60: 253-257.
  11. Surgical anatomy: The embryologic and anatomic of modern surgery / Skandalakis J. E., Colborn G. L., Weidman T. A. et al. N. Y.: McGraw-Hill; 2004.
  12. Langley J. N., Anderson H. K. The innervation within the prostate gland and seminal vesicle. J. Physiol. (Lond.) 1896; 20: 372-379.
  13. Latarjet A., Bonnet P. Le plexus hypogastrique chez l'homme. Lyon Chir. 1913; 9: 221-228.
  14. Benoit G., Merlaud L., Meduri G. et al. Anatomy of the prostatic nerves. Surg. Radiol. Anat. 1994; 16: 23-29.
  15. Rodrigues A. O., Machado M. T., Wroclawski E. R. Prostate innervation and local anesthesia in prostate procedures. Rev. Hosp. Clin. Fac. Med. S. Paulo 2002; 57: 287-292.
  16. Mallick S., Braud F., Fofana M. et al. Which anaesthesia should be recommended for prostate biopsy? West. Indian Med. J. 2005; 54: 135-138.
  17. Mutaguchi K., Shinohara K., Matsubara A. et al. Local anesthesia during 10 core biopsy of the prostate: comparison of 2 methods. J. Urol. (Baltimore) 2005; 173: 742-745.
  18. Vanni A. P., Schaal C. H., Costa R. P., Sala P. C. Is the periprostatic anesthetic blockade advantageous in ultrasound-guided prostate biopsy? Int. Braz. J. Urol. 2004; 30: 114-118.
  19. Hudson P. B., Finkle A. L., Henley J. Prostatic cancer. V. Improvements in pudendal nerve block anesthesia for surgical perineal biopsy of the prostate. Am. J. Surg. 1954; 87: 604-607.
  20. Hudson P. B., Finkle A. L. Prostatic cancer. II. Regional (pudendal plexus) block anesthesia for open perineal surgical biopsy of the prostate gland. Surgery 1953; 33: 308-311.
  21. Bors E., Comarr A. E., Moulton S. H. The role of nerve blocks in management of traumatic cord bladders: spinal anesthesia, subarachnoid alcohol injections, pudendal nerve anesthesia and vesical neck anesthesia. J. Urol. (Baltimore) 1950; 63: 653-666.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies