Local anesthesia for prostate biopsy by periprostatic lidocaine injection: A double-blind placebo controlled study

Dan Leibovici, Amnon Zisman, Yoram I. Siegel, Avishay Sella, Judy Kleinmann, Arie Lindner

Research output: Contribution to journalArticlepeer-review

115 Scopus citations

Abstract

Purpose: We determined the efficacy of anesthesia for prostate biopsy by periprostatic lidocaine injection. Materials and Methods: A total of 90 consecutive patients undergoing prostate biopsies were randomized into lidocaine and placebo groups of 45 each in double-blind fashion. A 5 ml. dose of 1% lidocaine or 0.9% sodium chloride was injected via 23 gauge needles inserted through the transrectal ultrasound probe working channel and aimed at the prostatic neurovascular bundles bilaterally. Patients completed a symptom questionnaire applying a visual analog scale of 0-none to 10-maximal addressing pre-procedure anxiety, overall pain and discomfort throughout the procedure, pain during biopsy punctures and patient tolerance, as judged by the operator. Student's t test was used to analyze continuous variables and the chi-square test was applied for categorical data. Linear regression was done to determine intervariable influences. Results: The average pain level throughout the procedure was 3.06 in the lidocaine group versus 4.15 in the control group (p = 0.04), while the pain level during biopsy punctures was 1.51 versus 3.98 (p = 0.0001) and patient tolerance was 1.06 versus 1.93 (p = 0.018). The level of discomfort throughout the procedure was lower in the lidocaine group with borderline significance (4.31 versus 5.24, p = 0.077). The lidocaine and control groups were comparable regarding average patient age (65 and 66 years, respectively). Prostate volume was similar in the 2 groups (68.5 versus 63 ml.). The median number of biopsy punctures was 7 and 8, respectively. Cancer was identified in 10 patients (22.2%) per group. Conclusions: Periprostatic lidocaine injection is an effective method of anesthesia for prostate biopsy.

Original languageEnglish
Pages (from-to)563-565
Number of pages3
JournalJournal of Urology
Volume167
Issue number2 I
DOIs
StatePublished - 2002
Externally publishedYes

Keywords

  • Biopsy
  • Lidocaine
  • Pain
  • Prostate
  • Questionnaires

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