Comparison of Pudendal Nerve Blockade, Tenoxicam Suppository and Rectal Lidocaine Gel Anesthesia for Transrectal Ultrasound-Guided Biopsy of the Prostate

Yıl 2009, Cilt: 16 Sayı: 3, 141 - 144, 01.06.2009

Süleyman Bulut Binhan Kağan Aktaş Cüneyt Özden; Özer Güzel Yaşar Pala Ali Memiş

Öz

Aim: We assessed the safety and efficacy of three different local anesthesia methods (pudendal nerve blockade, tenoxicam suppository and rectal lidocaine gel) before transrectal ultrasound (TRUS)-guided biopsy of the prostate in this study. Materials and Methods: In our prospective and controlled study, 136 consecutive patients were randomized into four groups: men in group 1 (n=41) received no anesthesia, group 2 (n=30) received intrarectal 10 cc 2% lidocaine gel 10 mins before biopsy, group 3 (n=31) received 20 mg tenoxicam suppository 30 mins before biopsy and pudendal nerve blockade was performed in group 4 (n=34) 10 mins before biopsy using 10 ml of 1% lidocaine. The patients were asked to grade the pain when TRUS probe was inserted and during the biopsy procedure using a 11-point linear visual analog scale (VAS) and their pain scores were noted. Results: There were statistically significant differences among four groups regarding the mean VAS scores during probe insertion (p=0.024) and biopsy (p=0.012). This significance was provided by the difference between the group 1 and 4 (p=0.015 for probe insertion and p=0.022 for biopsy with Tukey test). No statistically significant difference was found among the pain scores of group 1, 2 and, 3 during probe insertion and biopsy. Conclusions: Pudendal nerve blockade was effective in reducing pain both during the biopsy procedure and probe insertion, while suppository tenoxicam and rectal lidocaine gel had no significant anesthetic effect. Key words: Prostate Biopsy, Anesthesia, Pain, Pudendal Nerve Blockade, Tenoxicam Suppository

Anahtar Kelimeler

Prostate Biopsy, Anesthesia, Pain, Pudendal Nerve Blockade, Tenoxicam Suppository

Transrektal Ultrasonografi Kılavuzluğunda Prostat Biyopsisi İçin Pudental Sinir Bloğu, Supozituar Tenoksikam ve Rektal Lidokain Jel Anestezisinin Karşılaştırılması

Öz

Amaç: Bu çalışmada transrektal ultrasonografi (TRUS)-kılavuzluğunda prostat biyopsisi öncesi kullanılan üç farklı lokal anestezi yönteminin (pudental sinir bloğu, supozituar tenoksikam ve intrarektal lidokain jel) etkinlik ve güvenilirliği araştırıldı. Materyal ve metot: Prospektif ve kontrollü olan çalışmamızda toplam 136 hasta 4 gruba randomize edildi; grup 1'deki (n=41) hastalara anestezi uygulanmadı, grup 2'deki (n=30) hastalara biyopsiden 10 dk önce intrarektal 10 cc %2'lik lidokain jel, grup 3'deki (n=31) hastalarabiyopsiden 30 dk önce 20 mg supozituar tenoksikam, grup 4'deki (n=34) hastalara biyopsiden 10 dk önce 10 ml %1'lik lidokain kulanılarak pudental sinir bloğu uygulandı. Vizüel analog skala (VAS) kullanılarak hastalardan prob girişi ve biyopsi sırasındaki ağrıyı derecelendirmeleri (0-10 puan) istendi. Bulgular: Prob girişi (p=0.024) ve biyopsi (p=0.012) sırasındaki ortalama VAS skorları incelendiğinde 4 grup arasında istatistiksel olarak anlamlı fark mevcuttu. Bu sonuç grup 1 ve 4 arasındaki farktan kaynaklanıyordu (Tukey testinde prob girişi sırasında p=0.015 ve biyopsi sırasında p=0.022). Grup 1, 2 ve 3 arasında prob girişi ve biyopsi sırasındaki ortalama VAS skorları bakımından istatistiksel olarak önemli fark yoktu. Sonuç: Pudental sinir bloğu prob girişi ve biyopsi sırasındaki ağrıyı azaltmada etkili olurken supozituar tenoksikam ve intrarektal lidokain jelin önemli anestetik etkisine rastlanmamıştır. Anahtar kelimeler: Prostat Biyopsisi, Anestezi, Ağrı, Pudental Sinir Bloğu, Supozituar Tenoksikam

Anahtar Kelimeler

Prostat Biyopsisi, Anestezi, Ağrı, Pudental Sinir Bloğu, Supozituar Tenoksikam

Kaynakça

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• Corresponding Author: Cüneyt ÖZDEN, MD
• Cevizlidere Mah. 14. Cad. 12/25 06520 Balgat/ANKARA Tel: [phone]
• E -mail: [e-mail]