scholarly journals The effectivity of periprostatic nerve blockade for the pain control during transrectal ultrasound guided prostate biopsy

2013 ◽  
Vol 85 (2) ◽  
pp. 69 ◽  
Author(s):  
Alper Otunctemur ◽  
Murat Dursun ◽  
Huseyin Besiroglu ◽  
Emre Can Polat ◽  
Suleyman Sami Cakir ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Pain Control ◽  
Standard Procedure ◽  
Transrectal Ultrasound ◽  
Pain Scale ◽  
Nerve Blockade ◽  
Significant Difference ◽  
Lidocaine Gel ◽  
Group 2 ◽  
Group 1

Aim: Transrectal ultrasound (TRUS) guided prostete biopsy is accepted as a standard procedure in the diagnosis of prostate cancer. Many different protocoles are applied to reduce the pain during the process. In this study we aimed to the comparison of two procedure with intrarectal lidocaine gel and periprostatice nerve blockade respective- ly in addition to perianal intrarectal lidocaine gel on the pain control in prostate biop- sy by TRUS. Methods: 473 patients who underwent prostate biopsy guided TRUS between 2008-2012 were included in the study. 10-point linear visual analog pain scale(VAS) was used to evaluate the pain during biopsy. The patients were divided into two groups according to anesthesia procedure. In Group 1, there were 159 patients who had perianal-intrarectal lidocaine gel, in Group 2 there were 314 patients who had periprostatic nerve blockade in addition to intrarectal lidocain gel. The pain about probe manipulation was aseesed by VAS-1 and during the biopsy needle entries was evalu- ated by VAS-2. Results were compared with Mann-Whitney U and Pearson chi-square test. Results: Mean VAS-2 scores in Group 1 and Group 2 were 4.54 ± 1.02 and 2.06 ± 0.79 respectively. The pain score was determined significantly lower in the Group 2 (p = 0.001). In both groups there was no significant difference in VAS-1 scores, patient’s age, prostate volume, complication rate and PSA level. Conclusion: The combination of periprostatic nerve blockade and intrarectal lidocain gel provides a more meaningful pain relief compared to group of patients undergoing intrarectal lidocaine gel.

Echinococcosis of the liver in children

2021 ◽  
Vol 26 (4) ◽  
pp. 24-31
Author(s):  
A. Yu. Razumovsky ◽  
A. N. Smirnov ◽  
V. V. Kholostova ◽  
N. A. Al-Mashat ◽  
A. E. Stepanov ◽  
...  
Keyword(s):  
Standard Procedure ◽  
Treatment Protocol ◽  
Argon Plasma ◽  
Constant Frequency ◽  
Central Russia ◽  
Russian State ◽  
Significant Difference ◽  
Group 2 ◽  
Medical University ◽  
Group 1

Aim. The paper presents the experience of treatment of echinococcal cysts in children, which reflects most of the existing methods of treatment.Materials and methods. From 2010 to 2021, 81 patients with hepatic echinococcosis aged from 3 to 17 years (average 14.3 ± 1.3) were treated at the bases of the Department of Pediatric Surgeons of the Pirogov Russian State Medical University. All patients were examined according to the standard procedure, including: general clinical examination, examination of liver function, ultrasonography, chest X-ray, CT scan, blood test for IgG to echinococcus antigens. All children were divided into 2 groups according to the type of the surgery: in the group 1, 27 (33.3%) children underwent laparoscopic surgery; in the group 2, 54 (66.7%) children – laparotomy.Results. The treatment duration accounted 12.5 ± 3.1 days in group 1 and 9.2 ± 1.3 days in group 2 (p < 0.0067). In the group 1 the drainage duration was higher (6.8 ± 0.6) than in the group 2 (4.1 ± 0.3) (p < 0.03). Complications occurred in 7 patients, relapse of cysts – in 2 patients.Conclusion. Children with echinococcal cysts in Central Russia occur with a constant frequency and require to apply modern approaches in diagnosis and treatment. The classification and treatment protocol of echinococcosis, adopted by WHO, are easy-to-use and proves its effectiveness. There is no significant difference in germicidal agents’ effect on echinococcus and the effect on the development of relapse. The method of selection in the treatment of solitary and superficial cysts is laparoscopic interference with the mandatory application of a PAIR and a high-power aspirator. An important stage of the interference is the treatment of the fibrous capsule of the cyst, if it is impossible to completely remove it, with an argon-plasma coagulator.

scholarly journals COMPARISON OF PAIN INTENSITY BETWEEN LIDOCAINE GEL AND INTRAURETRAL TRAMADOL WITH LIDOCAINE GEL IN THE DJ STENT REMOVAL

2021 ◽  
Vol 28 (1) ◽  
pp. 74-78
Author(s):  
Cahyo Wijayanto ◽  
Doddy M. Soebadi ◽  
Wahjoe Djatisoesanto
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Pain Scale ◽  
Pain Rating ◽  
Stent Removal ◽  
Lidocaine Gel ◽  
Dj Stent ◽  
Group 2 ◽  
Urethral Injection ◽  
Group 1

Objective: To determine the difference in pain intensity between the administration of a combination of tramadol and intraurethral lidocaine gel with only lidocaine gel during the removal of DJ stents. Material & Methods: This study was a prospective randomized clinical trial with 22 patients that were divided into 2 groups. Group 1 was given a combination of tramadol and lidocaine gel urethral injection 3 to 5 minutes before DJ stent removal, whereas group 2 was given lidocaine gel urethral injection 3-5 minutes before the removal. The inclusion criteria in this study was all patients with a DJ stent placement with 1 to 3 months prior to release who were willing to participate. The Wong-Baker scale was used directly to determine the scale of pain during the procedure. Mann Whitney analysis was used to analyze the findings. Results:  Most patients in group 1 are shown to have a pain rating of 2. There are 2 patients with a high pain rating scale of 6 and 7. In group 2, most patients claimed that the procedure was painless. The average Wong-Baker pain scale in group 1 (2.9) compared to group 2 (0.36) was significantly different. Conclusion: The combination of intraurethral tramadol and 2% lidocaine gel can significantly decrease pain during DJ stent removal more effectively than sole intraurethral 2% lidocaine gel based on the Wong-Baker pain scale.

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.

Transrectal ultrasound guided prostatic nerve blockade for pain control during transrectal prostate biopsy

2005 ◽  
Vol 17 (4) ◽  
pp. 291-293
Author(s):  
Liu-ping Yang ◽  
Jun-hong Deng ◽  
Hong Zhong ◽  
Jian-bo Hu ◽  
Hong-ai Wei ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Pain Control ◽  
Transrectal Ultrasound ◽  
Ultrasound Guided ◽  
Nerve Blockade ◽  
Transrectal Prostate Biopsy

scholarly journals May ultrasound probe size influence pain perception of needle piercing during transrectal prostate biopsy? A prospective evaluation

2016 ◽  
Vol 88 (3) ◽  
pp. 223 ◽  
Author(s):  
Andrea Fabiani ◽  
Lucilla Servi ◽  
Alessandra Filosa ◽  
Fabrizio Fioretti ◽  
Valentina Maurelli ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
Prostate Biopsy ◽  
Pain Perception ◽  
Prostate Volume ◽  
Randomized Study ◽  
Digital Rectal Examination ◽  
Probe Size ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Introduction and Objective: Transrectal ultrasound guided prostate biopsy (TRUS-Bx) is the definitive step in the diagnosis of prostate cancer (CaP). Patients (pts) generally experience significant pain during the procedure at the point that biopsy should be accompanied by some form of anesthesia. Several different factors influence pain perception (PP) during TRUS-Bx. In our study we want to assess that the use of an ergonomic smaller sized probe reduces PP during the procedure independently from the administration of local anesthesia or pain relieving drugs. Materials and Methods: This was a prospective, randomized study in which 114 pts who underwent TRUS-Bx due to abnormal PSA and/or to digital rectal examination (DRE) suspicious findings were considered eligible. Pts were split in two TRUS-Bx groups into which we used two different sized ultrasound probes. In group 1, 61 pts underwent TRUS-Bx with ALOKA end fire probe (size 74 mm). In group 2, 53 pts underwent TRUS-Bx with B-K Type 8818 probe (size 58 mm). Both groups were treated with no local anesthesia or pain relieving drugs. Pain was evaluated three times using a 10-point visual analogue scale (VAS), during the DRE (VAS 1), during the insertion of the probe (VAS 2) and during the needle piercing (VAS 3). Results: Mean age of pts was 68.03 (SD 8.51); mean tPSA and mean prostate volume was 7.75 (SD 4.83) and 45.17cc (SD 17.7), respectively. The two groups were homogeneous respect to tPSA (p = 0.675) and to prostate volume (p = 0.296); age was significantly different (p = 0.04) between Group 1 (65.93) and Group 2 (70.43), whereas no statistically significant correlation between VAS 3 and age was observed (p = 0.179). Analyzing pain perception, we found no statistically significant difference between the two groups in DRE (VAS 1; p = 0.839); on the contrary, patients in Group 1 experienced on average more pain than other in Group 2 both during the insertion of the probe (VAS 2 3.49 vs 1.09; p &lt; 0.001) and during the needle piercing VAS 3 (2.8 vs 2.00; p &lt; 0.05). The discomfort during probe insertion and manipulation was perceived as very high (VAS 2 &gt; 5) in 42.6% of patients in Group 1 and in 9.4% in Group 2. Globally, the procedure was well tolerated (mean VAS score &lt; 3) in 77% of patients in Group 1 and in 90% in Group 2. The proportion of patients who experienced more than moderate pain (VAS &gt; 5) during needle piercing ranged 24.6 % in Group 1 to 18.9 % in Group 2. Conclusions: Patients who underwent a TRUS-Bx with the 58-mm circumference probe were found to experience lower degree of pain not only during the insertion of the probe through the anal sphincter, but also in the moment of needle piercing.

scholarly journals A Novel Enema Method Can Prevent Infectious Complications of Transrectal Ultrasound-Guided Prostate Biopsy: A Single-Center Experience

2021 ◽  
Author(s):  
Fatih Gokalp ◽  
Omer Koras ◽  
Didar GURSOY ◽  
Hakan Sigva ◽  
Sefa Burak PORGALI ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Prostate Biopsy ◽  
Protective Factor ◽  
Multivariable Analysis ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Infectious Complications ◽  
Significant Difference ◽  
Group 1

Background: Transrectal ultrasound biopsy is the preferred method for diagnosing prostate cancer, but it can cause infectious complications as a result of fluoroquinolone resistance. We aimed to explore the potential protective effect of a second rectal enema before biopsy. Methods: Between January 2015 and December 2020, 419 patients were assessed retrospectively. Patients with a history of anticoagulant use, uncontrolled diabetes, urological surgery, prostate biopsy, or recent hospitalization or overseas travel, as well as those with previous prostatitis, were excluded from the study. The patients were subsequently divided into two groups: Group 1 (n=223) had received one enema, on the morning of the biopsy, and Group 2 (n=196) had received two, with the additional enema administered half an hour before the procedure. Results: There was no significant difference between the groups in terms of age, BMI, diabetes, prostate-specific antigen (PSA) level, and prostate size (p=0.076, p=0.489, p=0.265, p=0.193, and p=0.661, respectively) or in relation to cancer detection (p=0.428). The median hospitalization date was significantly higher in Group 1 (p=0.003) as was UTI development (p=0.004). However, there was no significant difference in terms of fever and sepsis (p=0.524 and p=0.548, respectively). Additionally, subgroup analysis demonstrated that UTI was significantly lower in patients with diabetes mellitus who had received a second enema (p=0.004), though there was no significant difference in UTI between the groups in those without diabetes mellitus (p=0.215). Multivariable analysis showed that age and diabetes were significant risk factors for the development of UTI (p=0.002andp=0.003, respectively). Furthermore, the second enema was a significant protective factor for preventing UTI (p<0.001). Conclusion: Older age and the presence of diabetes mellitus are independent risk factors for UTI after prostate biopsy. A second enema procedure before biopsy may protect patients from related infectious complications and could therefore be used as an alternative preventative method.

scholarly journals The Effect of Two Different Doses Protocol of Bupivacaine for Femoral Block on Postoperative Analgesia: A Retrospective Analysis of Single Center Data

2021 ◽  
Author(s):  
Adem Selvi ◽  
Gökhan Yılıdız ◽  
Erbil Türksal ◽  
Rıdvan Özbek ◽  
Mustafa Caner Okkaoğlu ◽  
...  
Keyword(s):  
Side Effects ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Analgesic Efficacy ◽  
Pain Scale ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

INTRODUCTION: In our study, we aimed to compare the analgesic efficacy, side effect profile and its effect on opioid consumption of the femoral nerve block applied with different concentrations of local anesthetic agents (%0.5 bupivacaine and %0.25 bupivacaine) in the same volume (20 mL) after total knee replacement (TKR) operation. METHODS: The files of patients who underwent unilateral TKR surgery under spinal anesthesia between August 2018 and June 2019 were retrospectively reviewed. A total of 163 patients were included in the study, 81 patients in group 1 who received %0.25 bupivacaine, and 82 patients in group 2 who received %0.50 bupivacaine for femoral block. The highest visual analogue pain scale (VAS) scores in the postoperative 24 hours, the amount of tramadol requested and consumed with intravenous patient-controlled analgesia (PCA) devices, and whether there was a significant difference in terms of side effects (nausea, vomiting, motor and sensory deficit) were analyzed. RESULTS: The highest VAS score in group 1 was 2.95 ± 1.31, in group 2 it was 2.84 ± 1.06, and there was no significant difference between them. The mean consumption of tramadol was 197.04 ± 92.03 mg in group 1 and 208.05 ± 85.06 mg in group 2. There was no difference between the demand and consumption of tramadol and side effects. DISCUSSION AND CONCLUSION: 20 mL %0.25 bupivacaine for the femoral block provided the equivalent analgesic efficacy to the same volume of %0.50 bupivacaine. We think that the use of % 0.25 bupivacaine is a more reliable option to reduce systemic side effects, motor block risk and complications.

scholarly journals The Rectal Administration of Lignocaine Gel and Periprostatic Lignocaine Infiltration During Transrectal Ultrasound-Guided Prostate Biopsy Provides Effective Analgesia

2006 ◽  
Vol 88 (2) ◽  
pp. 218-221 ◽  
Author(s):  
EJ Siddiqui ◽  
S Ali ◽  
S Koneru
Keyword(s):  
Prostate Biopsy ◽  
Needle Biopsy ◽  
Standard Procedure ◽  
Transrectal Ultrasound ◽  
Rectal Administration ◽  
Ultrasound Guided ◽  
Prostate Needle Biopsy ◽  
Trus Biopsy ◽  
Group 2 ◽  
Probe Insertion

INTRODUCTION Transrectal ultrasound guided prostate needle biopsy (TRUS) is the standard procedure to diagnose or exclude prostate cancer. This procedure can be associated with significant discomfort, both on insertion of the ultrasound probe as well as on taking the biopsy. We evaluated a new technique for pain relief during TRUS biopsy. PATIENTS AND METHODS In Group 1 (n = 60), the biopsies were taken without any analgesia. In Group 2 (n = 60), 11 ml of Instillagel (2% lignocaine) was administered rectally prior to probe insertion and 5 ml of 1% lignocaine periprostatic injection was administered before taking the biopsy. The discomfort encountered during the procedure was graded by the patient on a scale ranging from no discomfort to mild, moderate and severe pain. RESULTS In Group 2, there was a marked reduction in the pain experienced during the procedure. The Chi-squared test for trend showed a significant association between the rectal administration of local anaesthetic gel and reduction in pain on probe insertion (P = 0.0001). There was also a significant association between the use of periprostatic lignocaine injection and reduction in pain on taking the biopsy (P < 0.0001). CONCLUSIONS The use of lignocaine gel prior to probe insertion and periprostatic infiltration of lignocaine before taking the needle biopsy significantly reduces the pain experienced by the patient during TRUS-guided prostate biopsy.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

Tuberculosis of the meninges and central nervous system. Experience of clinical diagnostics in St. Petersburg for 50 years

MedAlliance ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 14-24
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Medical Errors ◽  
Clinical Diagnostics ◽  
Lethal Outcome ◽  
Significant Difference ◽  
Group 2 ◽  
Allergic Vasculitis ◽  
Tuberculosis Meningitis ◽  
Group 1

The clinic and diagnostics of tuberculosis meningitis (TM) in 926 patients treated in St. Petersburg hospitals in 1965–1994 (group 1) and in 1995–2018 (group 2) is presented. The TM clinic is demonstrated to be determined by the form of tuberculosis and its characteristic generalization nature in the presence of repeated waves of bacteremia and allergic vasculitis of greater or lesser severity. There is clinical peculiarity of TM in primary pulmonary tuberculosis and its early large-focal and late miliar generalization, as well as in hematogenous tuberculosis. In patients of the 1st and 2nd groups the TM clinic shows in some respects a noticeable similarity, in others — a significant difference. Despite the typical symptoms, early diagnosis of TM took place in less than 20% of patients. Clinical examples illustrating the unusual development of TM, contrasting with its usual course, are given. A number of objective and subjective factors contributing to the adverse evolution of TM and its lethal outcome are discussed. These include the peculiarity of modern tuberculosis, especially when associated with HIV infection, as well as medical errors associated with ignorance of the pathogenesis of tuberculosis and failure to comply with the minimum examination for tuberculosis.

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