2062 A SYSTEMATIC REVIEW AND META-ANALYSIS COMPARING THREE METHODS OF ANESTHESIA FOR TRANSRECTAL ULTRASOUND GUIDED PROSTATE BIOPSY: PERIPROSTATIC NERVE BLOCK, INTRARECTAL TOPICAL ANESTHESIA AND THEIR COMBINATION

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening IV1 Apr 20122062 A SYSTEMATIC REVIEW AND META-ANALYSIS COMPARING THREE METHODS OF ANESTHESIA FOR TRANSRECTAL ULTRASOUND GUIDED PROSTATE BIOPSY: PERIPROSTATIC NERVE BLOCK, INTRARECTAL TOPICAL ANESTHESIA AND THEIR COMBINATION Liangren Liu, Ping Han, Yuchun Zhu, Xin Wei, Haichao Yuan, Shuo Zheng, and Qiang Wei Liangren LiuLiangren Liu Chengdu, China, People's Republic of More articles by this author , Ping HanPing Han Chengdu, China, People's Republic of More articles by this author , Yuchun ZhuYuchun Zhu Chengdu, China, People's Republic of More articles by this author , Xin WeiXin Wei Chengdu, China, People's Republic of More articles by this author , Haichao YuanHaichao Yuan Chengdu, China, People's Republic of More articles by this author , Shuo ZhengShuo Zheng Chengdu, China, People's Republic of More articles by this author , and Qiang WeiQiang Wei Chengdu, China, People's Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2227AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To review the current evidence to determine the contemporary status of periprostatic nerve block (PNB), intrarectal topical anesthesia(IRTA) and their combination in the pain control during TRUS guided prostate biopsy. METHODS A comprehensive search of the literature was performed in April, 2011 using Medline, Embase and Cochrane central register of controlled trials. All randomized controlled trial (RCT) related were included.Mean pain scores after the biopsy procedure and after the probe insertion and adverse events were evaluated. Heterogeneity of the included RCTs was analyzed using the chi-square test on N-1 degree of freedom, with an alpha of 0.10 and with I2 test.Meta-analyses were performed by the Review Manager 5.0. RESULTS 429 studies were initially identified from the electronic database and hand search£¬67 RCTs was assessed in the meta-analysis. (1) PNB, IRTA and their combination group had less mean pain during biopsy procedure than placebo or control group(PNB vs control: MD: −2.14, 95% CI: −2.52- −1.76, p<0.00001; PNB vs placebo: MD: −1.80, 95% CI: −2.45- −1.15, p<0.00001; IRTA vs control: MD: −0.99, 95%CI: −1.68- −0.29, p=0.005; IRTA vs placebo: MD: −0.56, 95% CI: −0.99- −0.13, p=0.01; PNB combined with IRTA vs control: MD: −2.17, 95% CI: −3.31- −1.03, p=0.0002; PNB combined with IRTA vs placebo: MD: −2.65, 95%CI: −3.30- −2.00, P<0.00001). (2) IRTA could significantly reduce pain during probe insertion comparing with control and placebo(IRTA vs control: MD: −2.39, 95% CI:−4.21- −.057, p=0.010; IRTA vs placebo: MD: −1.23, 95% CI: −1.58- −0.88, p<0.00001). (3) PNB group had less pain after the prostate biopsy than IRTA group ( MD: 1.39; 95%CI: 0.81-1.98; p<0.00001). (4) PNB combined with IRTA could significantly reduce pain during biopsy procedure compared with PNB and IRTA, respectively (PNB combined with IRTA vs PNB: MD: −0.40, 95% CI: −0.74- −0.05, p=0.03; PNB combined with IRTA vs IRTA: MD: −1.15, 95% CI: −2.05- −0.26, p=0.01). (5) No statistically significant differences were found in adverse events or serious events for three anesthesia method compared to placebo and control, respectively. CONCLUSIONS (1) PNB, IRTA and PNB combined with IRTA were efficacious and safe for patients undergoing TRUS guided prostate biopsy. (2) IRTA could reduce pain after probe insertion. (3) PNB was more effective in reducing pain after biopsy procedure than IRTA. (4) PNB combined with IRTA was the most effective method in reducing pain after prostate biopsy. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e832 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Liangren Liu Chengdu, China, People's Republic of More articles by this author Ping Han Chengdu, China, People's Republic of More articles by this author Yuchun Zhu Chengdu, China, People's Republic of More articles by this author Xin Wei Chengdu, China, People's Republic of More articles by this author Haichao Yuan Chengdu, China, People's Republic of More articles by this author Shuo Zheng Chengdu, China, People's Republic of More articles by this author Qiang Wei Chengdu, China, People's Republic of More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...