Efficacy Of Periprostatic Nerve Block Research Articles

Research on the influencing factors of periprostatic nerve block anaesthesia

Objective To investigate the influence factors of periprostatic nerve block(PNB) anaesthesia. Methods A total of 375 patients who underwent prostate biopsy under PNB were analyzed retrospectively from July 2014 to February 2018. It was evaluated the correlation of the anesthetic efficacy of PNB with age, prostate volume, PSA, body mass index, spouse, degree of education, occupation, diabetes history, operation time, number of cores and clinical stage. A visual analog scale (VAS) were used to assess pain of the patients. Univariate analysis was performed for each factor. Factors found to be significantly different that were further analyzed using multiple linear regression analysis. Results The average VAS score of all patients was 2.5±1.4. Univariate analysis showed that the following factors were associated with the anesthetic efficacy of PNB: age (F=2.262, P=0.029), prostate volume (F=2.529, P=0.011), occupation (F=2.203, P=0.042), operation time (F=2.233, P=0.033), number of cores (F=2.401, P=0.016) and diabetes history (F=2.271, P=0.027). Multiple linear regression analysis showed that prostate volume (t=3.742, P<0.001), number of cores (t=4.252, P<0.001) and diabetes history (t=-2.242, P=0.032) were independent factors. The VAS score of patients with large volume prostate was higher than that of small volume prostate. The number of cores was high, and the VAS score was higher. However, diabetic patients had lower VAS score. Conclusions The anesthetic efficacy of PNB was poor in patients with larger prostate volume and more number of cores. However, patients with chronic diabetes had better pain tolerance. Key words: Periprostatic nerve block anaesthesia; Pain; Influencing factors

Effect of prostate volume on the peripheral nerve block anesthesia in prostate biopsy

To evaluate the anesthetic efficacy of periprostatic nerve block in transrectal ultrasound(TRUS) guided biopsy on different prostate volume. A total of 568 patients received prostate biopsy in Department of Urology, Subei People's Hospital from May 2013 to September 2015 were retrospectively studied. All patients were divided into local anesthesia group and nerve block group according to different way of anesthesia. Then each group was divided into four subgroups(20-40 ml, >40-60 ml, >60-100 ml and >100 ml subgroups) according to different prostate volume range. After being anaesthetized successfully, patients in two groups underwent prostate biopsy, visual analogue scale(VAS) scores, visual numeric scale(VNS)scores and complications were recorded and analyzed. At inter-group and intra-group in local anesthesia group and nerve block group, Mann-Whitney U test of non-parametric analysis and single factor variance analysis were used to compare the VAS scores and the VNS scores respectively, and chi-square test was used to compare the rates of complication. The VAS scores of four subgroups: local anesthesia group: 1.9±0.9, 2.8±1.5, 3.8±2.3 and 5.3±2.5; nerve block group: 1.5±0.7, 2.0±0.8, 2.9±1.7 and 4.2±2.0. The VNS scores: local anesthesia group: 3.4±0.6, 2.9±0.6, 2.7±0.5 and 1.6±0.7; nerve block group: 3.7±0.5, 3.3±0.4, 3.0±0.8 and 2.0±0.7. The VAS scores and the VNS scores had significant differences (Z=-3.637-98.253, all P<0.05) at inter-group or intra-group level. For the complication rates of operation, hematuria, blood, urinary retention were significant differences (F=1.347-15.402, all P<0.05) at intra-group level. But there were no significant differences at inter-group level(P>0.05). Compared with local anesthesia, ultrasound guided prostate peripheral nerve block anesthesia has great analgesic effect and high safety, but for patients with a large prostate volumethe analgesic effect is inefficiency.

Comparative Evaluation of Periprostatic Nerve Block with and without Intraprostatic Nerve Block in Transrectal Ultrasound-Guided Prostatic Needle Biopsy

PurposeControversy exists over the pain during prostate biopsy. Periprostatic nerve block is a commonly used anaesthetic technique during transrectal ultrasound (TRUS)-guided prostate biopsy. The recent trend toward increasing the number of cores has become popular. This practice further increases the need for a proper anaesthetic application. We compared the efficacy of periprostatic nerve block with or without intraprostatic nerve block.Materials and MethodsWe conducted a prospective double-blinded placebo-controlled study at our institute with 142 consecutive patients. Patients were randomly assigned into 3 groups. Group 1 received periprostatic nerve block with intraprostatic nerve block with 1% lignocaine. Group 2 patients were administered periprostatic nerve block only with 1% lignocaine. Group 3 received no anaesthesia. Patients were asked to grade their level of pain by using an 11-point linear analogue scale at the time of ultrasound probe insertion, at the time of anaesthesia, during biopsy, and 30 minutes after biopsy.ResultsThe study groups were comparable in demographic profile, prostate-specific antigen (PSA) level, and prostate size. The mean pain scores at the time of biopsy in groups 1, 2, and 3 were 2.70, 3.39, and 4.16, respectively. Group 1 recorded the minimum mean pain score of 2.70 during prostate biopsy, which was significantly lower than the scores of groups 2 and 3 (p<0.001). There were no significant differences in pain scores among the 3 groups during probe insertion, during anaesthesia, or at 30 minutes after biopsy (p>0.05).ConclusionsPeriprostatic nerve block with intraprostatic nerve block provides better pain control than does periprostatic nerve block alone in TRUS-guided prostate biopsy.

UP-02.140 Comparison of Efficacy of Periprostatic Nerve Block Versus Combination of Periprostatic Nerve Block and Intraprostatic Anaesthesia During Transrectal Ultrasound Guided Prostate Biopsy

Controversy exists over the pain during prostate biopsy. Periprostatic nerve block is a commonly used anaesthetic technique during Transrectal ultrasonography (TRUS) guided prostate biopsy. Recent trend toward increasing the number of cores has been popularized. This practice further increased the need for proper anesthetic application. We compared the efficacy of periprostatic nerve block vs combination of periprostatic nerve block and intraprostatic anaesthesia during TRUS guided prostate biopsy.

Transrectal ultrasound guided multi‐core prostate biopsy: Pain control: Results of 106 patients

To determine the efficacy of periprostatic nerve block (PPNB) for control of transrectal ultrasound (TRUS)-guided multicore prostate biopsy-related pain. A total of 106 cases with suspicion of prostate cancer underwent TRUS-guided multicore prostate biopsy under local anesthesia using a total of 10 ml of 1% lidocaine for each patient. Lidocaine was injected around the neurovascular bundle at the base of the prostate just lateral to the seminal vesicle-prostate junction. The pain score was assessed using visual analog pain score from 0 to 10. All patients were questioned for whether they would accept repeat biopsy or not, if necessary. Pain score ranged from 0 to 5 (mean: 1.4). Thirty-five percent (37/106) of patients reported a score of 0, whereas 17% (18/106), 32% (34/106), 8.4% (9/106), 6.7% (7/106), 0.9% (1/106) reported pain scores of 1, 2, 3, 4, and 5, respectively. There were no pain scores of 6-10. Answers for the question "would you accept repeat biopsy or not, if necessary?" was "yes" for 82% (87/106) of the patients. PPNB prior to multi-core TRUS-guided prostate biopsy is an easy, safe, and effective technique for the control of procedure-related pain.

Periprostatic nerve block (PNB) alone vs PNB combined with an anaesthetic‐myorelaxant agent cream for prostate biopsy: a prospective, randomized double‐arm study

To compare the efficacy of periprostatic nerve block (PNB) alone vs PNB combined with the local administration of a 1.5% lidocaine/0.3% nifedipine cream (Antrolin, Bracco, Milan, Italy). In a prospective, randomized, double-arm study, 200 patients were randomized to receive PNB alone (group A, 100) or PNB combined with a previous administration of the topical anaesthetic Antrolin (group B, 100). The PNB was applied by infiltrating bilaterally a solution of 5 mL lidocaine 1% and naropine 0.75%. Patients were asked to complete visual analogue scale (VAS) questionnaire (0-10) to score pain and discomfort during probe insertion (VAS1), PNB (VAS2), cores (VAS3), 30 min after biopsy (VAS4), the evening of the procedure (VAS5), and the day after biopsy (VAS6). Pain during probe insertion in group B was significantly less than in group A (VAS1 0.82 vs 2.9; P < 0.001). Pain during periprostatic infiltration was also lower in group B than group A (VAS2 1.4 vs 3.48; P < 0.001). Pain control was similar during biopsy in the two groups (VAS3 1.28 vs 1.2; P = 0.69). The pain scored at VAS4 was significantly less in group B (0.7 vs 1.86, P < 0.001), as was VAS5 (0.68 vs 1.3, P < 0.001). There was no difference in pain perception the day after biopsy (VAS6, 0.32 vs 0.22, P = 0.14). Antrolin placed with PNB is better than PNB alone in reducing pain and discomfort during transrectal-ultrasonography guided prostate biopsy.

Does periprostatic nerve block with local anesthetic reduce pain during prostate biopsy?

SYNOPSISBACKGROUNDDespite the pain associated with prostate biopsy, many procedures are performed without analgesia. Periprostatic nerve block (PNB) with local anesthesia is a popular technique, but its overall efficacy is not known.OBJECTIVETo determine the efficacy of PNB with local anesthesia for