The local anesthesia for the prostatic biopsies echo-guided: Forward-looking randomized study comparing two methods [L'anesthésie locale pour les biopsies prostatiques écho-guidées: étude prospective randomisée comparant deux méthodes]

摘要

Introduction: The realization of the prostatic biopsies is a painful act. The objective of our work was to compare the analgesic efficiency of the injection of the lidocaine at the level of periprostatics laterals and apical areas compared with the use of gel of lidocaine intrarectal associated with the taking of oral tramadol. Patients and methods: Between November 2007 and December 2009, 60 patients admitted in the service of urology of the university hospital Mohammed VI of Marrakesh for prostatic biopsies were randomized in two groups. The group 1 (30 patients) received two tablets from tramadol 50. mg with 10. mL of gel of lidocaine 2% intrarectal while 30 patients of the group 2 received 10. mL from lidocaine 2% injected at the level of periprostatics laterals and apicales. The pain was estimated by a visual analog scale (AVS) at the introduction of the probe of echography (AVS 1), at the time of the biopsy (AVS 2) and 20. minutes later (AVS 3). Results: There was no significant difference between both groups concerning AVS 1 means. The average score of the pain was significantly lower in the group 2 for the AVS 2 and AVS 3. Conclusion: The periprostatics anesthesia assured a better control of the pain at the time of the prostatic biopsy and 20. minutes later, without increase of the complications. We recommend it to decrease the pain and the discomfort related to this technique.