Prospective randomized trial of spinal saddle block versus periprostatic lignocaine for anesthesia during transrectal prostate biopsy.

摘要

OBJECTIVE: To compare the efficacy and tolerability of spinal saddle block vs periprostatic lignocaine injection for anesthesia during transrectal prostate biopsy. METHODS: A total of 75 patients were randomized to undergo prostate biopsy in 3 groups (n = 25). Group 1 had no anesthesia, group 2 had periprostatic lignocaine injection, and group 3 had spinal saddle block. All patients had sextant biopsy. The groups were assessed for pain, level of cooperativeness, willingness to have a repeat biopsy, complication rate, and the duration of the procedure. RESULTS: The mean age in the groups were, respectively, 65.0 (+/-5.7) (group 1), 65.5 (+/-9.3) (group 2), and 68.6 (+/-6.3) (group 3) years. There was no statistical difference between the groups with respect to age, prostate volume, number of biopsies taken, and the prostate-specific antigen. The mean visual analog score in the groups was, respectively, 5.7 (+/-2.3), 4.6 (+/-2.3) and 0.7 (+/-1.6) for groups 1-3. The difference between groups 1 and 2 was not statistically significant (P = .181), whereas the difference between groups 2 and 3 and groups 1 and 3 was highly statistically significant (P = .000). There were also highly statistically significant differences in levels of cooperativeness and duration of the procedure between group 3 and groups 1 and 2. The differences between the groups with respect to complication rates and willingness to have a repeat biopsy were not statistically significant. CONCLUSIONS: Spinal saddle block was a more effective method of anesthesia than periprostatic lignocaine. It did not sacrifice the current outpatient/day case setting for prostate biopsy. It could be offered routinely to patients undergoing prostate biopsy.