scholarly journals Transrectal Ultrasound-Guided Prostate Biopsy, Periprostatic Local Anesthesia and Pain Tolerance

2010 ◽  
Vol 10 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Mustafa Hiroš ◽  
Mirsad Selimović ◽  
Hajrudin Spahović ◽  
Sabina Sadović ◽  
Ediba Spužić-Čelić
Keyword(s):  
Local Anesthesia ◽  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Pain Tolerance ◽  
Ultrasound Guided ◽  
Lidocaine Group ◽  
Pain Scores ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

We have evaluated objectively pain tolerance in transrectal ultrasound-guided prostate biopsy (TRUS) using local periprostatic per rectal anesthesia as compared to the conventional method. From November 2008 to May 2009, 90 patients underwent transrectal ultrasound-guided prostate biopsy at Department of Urology, Clinical Center University Sarajevo. 90 patients who fulfilled the inclusion criteria were randomized into 3 groups of 30 patients each. Group 1 received periprostatic local anesthesia with 2% lidocaine, group 2 received Voltaren supp placed in rectum an hour before biopsy while group 3 received no local anesthesia. Pain scale responses were analyzed for each aspect of the biopsy procedure with a visual analog scale of 0-none to 10-maximal. There was no difference between the 3 groups in pain scores during digital rectal examination, intrarectal injection and probe insertion. The mean pain scores during needle insertion in group 1 receiving periprostatic nerve block and in group 2 receiving Voltaren supp were 3,10 ± 2,32 and 5,15 ± 2,01 respectively. In group 3 (no local anesthesia), mean pain scores were 6,06 ± 2,95 which was found to be significantly different (p < 0,001). However, morbidity after the biopsy was not statistically different between all 3 groups. TRUS-guided prostate biopsy is a traumatic and painful experience, but the periprostatic blockage use is clearly associated with more tolerance and patient comfort during the exam. It is an easy, safe, acceptable and reproducible technique and should be considered for all patients undergoing TRUS biopsy regardless of age or number of biopsies.

Pain Scores and Local Anesthesia for Transrectal Ultrasound-Guided Prostate Biopsy in Patients with Anorectal Pathologies

2007 ◽  
Vol 21 (11) ◽  
pp. 1367-1370 ◽  
Author(s):  
Erkan Demir ◽  
Mete Kilicer ◽  
Selahattin Bedir ◽  
Guldem Kilciler ◽  
Koray Erten ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Ultrasound Guided ◽  
Pain Scores

scholarly journals Peritonsillar infiltration of lidocaine Hcl versus intravenous pre-incisional lornoxicam in reducing post-tonsillectomy pain: this is a prospective, randomized, double-blinded, placebo-controlled study

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Reham Farouk Zittoon ◽  
Eman Youssef Hassan ◽  
Ibrahem Hassan Ibrahem ◽  
Maged Mohamed Baher
Keyword(s):  
Controlled Study ◽  
Lidocaine Group ◽  
Intraoperative Bleeding ◽  
Peritonsillar Infiltration ◽  
Pain Scores ◽  
Lidocaine Hcl ◽  
Group 3 ◽  
Group 2 ◽  
Double Blinded ◽  
Group 1

Abstract Background Tonsillectomy is one of the most common procedures in otorhinolaryngology practice where analgesics are required for pain-relief especially in children. To compare the efficacy of using peritonsillar infiltration of lidocaine Hcl versus intravenous preincisional lornoxicam in reducing post tonsillectomy pain. Results Prospective, randomized, double-blinded, placebo-controlled study. Ninety-nine patients from age 12 to 18 years old, prepared for tonsillectomy. Patients were randomly subdivided into three groups as 33 patient in each group to receive either lidocaine (group 1), lornoxicam (group 2), or saline as a placebo (group 3). Anesthesia was induced using intravenous fentanyl and propofol, while endotracheal intubation was facilitated with rocuronium and maintenance by halothan. Intraoperative bleeding, pain scores, interval until first order for analgesic. The postoperative complications including bleeding, hypoxia, nausea, and vomiting also were observed. Pain scores at rest were significantly lower in group 2 than groups 1 and 3 at all observation times. Similarly, pain scores were lower in group 2 during the first 5 postoperative hours. The mean time for rescue analgesic was 276 min in group 2, 91 min in group 1, and about 60 min in group 3. No significant differences were noted for intraoperative bleeding. Conclusion The use of lornoxicam 16 mg at preoperative phase gave good control of immediate post tonsillectomy pain. Level of evidence 3b

scholarly journals Comparison between “In-bore” MRI guided prostate biopsy and standard ultrasound guided biopsy in the patient with suspicious prostate cancer: Preliminary results

2019 ◽  
Vol 91 (2) ◽  
Author(s):  
Daniele D’Agostino ◽  
Federico Mineo Bianchi ◽  
Daniele Romagnoli ◽  
Paolo Corsi ◽  
Marco Giampaoli ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Ultrasound Guided ◽  
Grade Group ◽  
Prostatic Biopsy ◽  
Group 3 ◽  
Total Psa ◽  
Group 1

Objectives: To evaluate the detection rate of prostate cancer (PCa) in patients who underwent to “in bore” Magnetic Resonance Imaging -guided prostate (MRI-GB) biopsy compared to the standard transrectal ultrasound guided prostate biopsy (TRUS-GB). Materials and methods: Between January 2017 and March 2015 a cohort of 39 consecutive patients was prospectively enrolled. All the patients underwent an "in-bore" guided MRI prostatic biopsy and subsequently ultrasound-guided standard prostate biopsy. Results: Median age of patients was 65.5 years (SD ± 6.6), median total PSA serum level was 6.6 ng/ml (SD ± 4.1), median prostate total volume was 51.1 cc (SD ± 26.7). Thirty of 39 (76.9%) were biopsy-naïve patients while 7/39 (17.9%) had at least one previous negative random TRUS-GB; 2/39 (5.1%) patients were already diagnosed as PCa and were on active surveillance. In 18/39 (53.8%) men Pca was diagnosed; as regards the MRI-GB results related to the PI-RADS score, biopsies of PIRADS 3 lesions were positive in 5/18 cases (27.8%), while the number of positive cases of PI-RADS 4 and 5 lesions was 7/11 (63.6%) and 6/10 (60%)respectively. At the histological examination, 4/39 (10.3%) had a PCa ISUP grade group 1, 11/39 (28.2%) had a ISUP 2, 6/39(15.4%) had a ISUP grade group 3 and 2/39 (5.1%) had a ISUP 4-5. Conclusions: MRI-GB represents a promising technique that may offer some of advantages compared to standard systematic TRUSGB. Our preliminary experience in MRI-GB resulted safe and feasible and represents a viable procedure for the diagnosis and characterization of PCa.

S29 Transrectal ultrasound-guided prostate biopsy, periprostatic local anesthesia and pain tolerance

2009 ◽  
Vol 8 (8) ◽  
pp. 616
Author(s):  
M. Hiros ◽  
M. Selimovic ◽  
H. Spahović ◽  
S. Sadović ◽  
E. Spužić
Keyword(s):  
Local Anesthesia ◽  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Pain Tolerance ◽  
Ultrasound Guided

Epidural Clonidine or Bupivacaine as the Sole Analgesic Agent during and after Abdominal Surgery 

1999 ◽  
Vol 90 (5) ◽  
pp. 1354-1362 ◽  
Author(s):  
Marc De Kock ◽  
Philippe Gautier ◽  
Athanassia Pavlopoulou ◽  
Marc Jonniaux ◽  
Patricia Lavand'homme
Keyword(s):  
High Dose ◽  
General Anesthetics ◽  
Visual Analogue Pain ◽  
Pain Scores ◽  
Arterial Blood ◽  
Sedation Scores ◽  
Group 3 ◽  
Group 2 ◽  
High Doses ◽  
Group 1

Background The rationale of this study was to compare high-dose epidural clonidine with a more commonly used agent, such as bupivacaine. This was performed to give a more objective idea of the relative analgesic potency of epidural clonidine. Methods Sixty patients undergoing intestinal surgery during propofol anesthesia were studied. At induction, the patients received epidurally a dose of 10 micrograms/kg [corrected] clonidine in 7 ml saline followed by an infusion of 6 micrograms [corrected] x kg(-1) x h(-1) (7 ml/h) (group 1, n = 20), a dose of 7 ml bupivacaine, 0.5%, followed by 7 ml/h bupivacaine, 0.25% (group 2, n = 20), or a dose of 7 ml bupivacaine, 0.25%, followed by 7 ml/h bupivacaine, 0.125% (group 3, n = 20). Intraoperatively, increases in arterial blood pressure or heart rate not responding to propofol (0.5 mg/kg) were treated with intravenous alfentanil (0.05 mg/kg). Additional doses of propofol were given to maintain an adequate bispectral index. The epidural infusions were maintained for 12 h. In cases of subjective visual analogue pain scores up to 5 cm at rest or up to 8 cm during coughing, the patients were given access to a patient-controlled analgesia device. Results During anesthesia, patients in group 1 required less propofol than those in groups 2 and 3 (78 [36-142] mg vs. 229 [184-252] mg and 362 [295-458] mg; P &lt; 0.05) and less alfentanil than patients in group 3 (0 [0-0] mg vs. 11 [6-20] mg; P &lt; 0.05). Analgesia lasted 380 min (range, 180-645 min) in group 1 versus 30 min (range, 25-40 min) in group 2 and 22 min (range, 12.5-42 min) in group 3 (P &lt; 0.05). There was no suggestion of a hemodynamic difference among the three groups except for heart rates that were significantly reduced in patients in group 1. Sedation scores were significantly higher in this group during the first 2 h postoperatively. Conclusion Our results show that high doses of epidural clonidine potentiate general anesthetics and provide more efficient postoperative analgesia than the two bupivacaine dosage regimens investigated.

scholarly journals Interpleural Administration of Bupivacaine after Cholecystectomy: A Comparison with Intercostal Nerve Block

1989 ◽  
Vol 17 (3) ◽  
pp. 269-274 ◽  
Author(s):  
D. W. Blake ◽  
G. Donnan ◽  
J. Novella
Keyword(s):  
Local Anaesthetic ◽  
Intercostal Nerve ◽  
Intercostal Nerve Block ◽  
Nerve Blocks ◽  
Pain Scores ◽  
Lower Pain ◽  
Chest X Ray ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Pethidine requirements and verbal pain scores were recorded in 36 patients after cholecystectomy via subcostal incision. All patients also received 20 ml 0.5% bupivacaine with adrenaline 1/200,000. Group 1 (12 patients) received unilateral intercostal nerve blocks. Interpleural catheters were inserted through the 8th intercostal space in the remaining patients; 12 received local anaesthetic via the catheter immediately after surgery (Group 2) and 12 were given local anaesthetic at three hours (Group 3). Small asymptomatic pneumothoraces were noted on chest X-ray in six of the 24 patients with interpleural catheters. Both types of local anaesthesia produced lower pain scores than pethidine alone (P < 0.05) with 25% of intercostal nerve blocks and 63% of interpleural catheters requiring no pethidine in the following three hours. The provision of catheter ‘top-ups’ between six and 18 hours after surgery also resulted in lower pain scores and a reduction in pethidine requirements (P < 0.05).

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