De la Cruz-Gutiérrez SM, Castellanos-Hernández H, Figueroa-Zarza M, Uriarte–Félix WJ, Schröeder-Ugalde IM, Llaven-Gómez GA, Landa-Soler M, López-Mariscal MC

Language: Spanish
References: 9
Page: 75-80
PDF size: 156.65 Kb.

ABSTRACT

Introduction: Ultrasound-guided transrectal biopsy of the prostate is the procedure of choice for evaluating patients suspected of presenting with prostate cancer. It is an invasive study that can be associated with slight discomfort at the biopsy site or can increase to severe pain, making the use of anesthesia imperative. The present study compared the use of dextropropoxyphene versus placebo in patients undergoing transrectal prostate biopsy.
Methods: A total of sixty patients undergoing ultrasoundguided transrectal biopsy of the prostate from November 2009 to April 2010 were randomly divided into two groups. In Group 1 (n = 30) simple apical block technique was used, employing single application of 5 mL of lidocaine at 2% plus 65 mg oral dextropropoxyphene thirty minutes before procedure. In Group 2 (n = 30) simple apical block technique was used, employing single application of 5 mL of lidocaine at 2% plus placebo thirty minutes before procedure. Pain at transducer introduction and at the taking of biopsy samples was compared between groups using the Visual Analog Scale for measuring pain.
Results: Mean pain at transducer introduction was 4.77±2.95 in Group 1 and 5.27±2.70 in Group 2. Mean pain when biopsy samples were taken was 2.23±2.25 in Group 1 and 3.33±1.97 in Group 2. Ramsay Sedation Scale after procedure was 1.63±0.490 in Group 1 and 1.50±0.509 in Group 2.
Conclusions: It was concluded in the present study that the administration of dextropropoxyphene together with simple apical block was more effective in regard to pain control during ultrasound-guided transrectal biopsy of the prostate than the administration of placebo.

REFERENCES

1. Collins GN, Lloyd SN, Heihir M, McKelvie. Multiple transrectal ultrasound guided prostatic biopsies, true morbidity and patient accentance. Br J Urol 1993;71:460-463.

2. International Association for the Study of Pain (IASP). En: http://www.iasppain.org/terms-p.html. Acceso: 29 de agosto de 2003.

3. Collins G N, Lloyd S N, Hehir M, et al. Multiple transrectal ultrasoundguided prostatic biopsies-true morbidity and patient acceptance. Br J Urol 1993;71:460.

4. Irani J, Fournier F, Bon D, et al. Patient tolerance of transrectal ultrasound-guided biopsy of the prostate. Br J Urol 1997;79:608.

5. Benoit G, Mrlaud L, Meduri G, et al. Anatomy of the prostatic nerves. Surg Radiol Anat 1994;16:23-29.

6. Martin WR. Pharamacology of opioids. Pharamacology Rev 1983;35:283-323.

7. Evans CJ, Hammond DL, Frederickson CA. The opiod peptides. En: The opiates receptors, Ed. By G.W. Pasternak, The human press, Clifton, New Jersey 1988;pp:23-57.

8. Nash PA, Bruce JE, Indudhara R, et al. Transrectal ultrasound guided prostatic nerve blockage eases systematic needle biopsy of the prostate. J Urol 1996;155:607.

9. Soloway MS, Öbek C. Periprostatic local anestesia before ultrasound guided prostate biopsy. J Urol 2000;163:172.