Comparison of local infiltration anesthesia and mucous surface anesthesia in trans-rectal ultrasound-guided prostate biopsy

Background: To compare the efficacy and safety of local infiltration anesthesia and mucous surface anesthesia in patients undergoing trans-rectal ultrasound-guided (TRUS guided) prostate biopsy. Methods: Patients with suspected prostate cancer undergoing TRUS guided prostate biopsy were randomly divided into two groups between January 2018 and March 2019. Local infiltration anesthesia was performed in the experimental group with lidocaine; while the control group was treated with mucous surface anesthesia. We collected baseline characteristics. Residual urine volume was measured twice: before biopsy, the first micturition after biopsy. Associated complications, positive rate of biopsy, visual analog pain scale (VAS) and Gleason score were recorded. Results: The study included 78 patients. The pain score of experimental group was significantly lower than the control group. Experimental group had lower rate of urinary retention and catheterization. Both groups had similar positive rate of biopsy, residual urine volume, Gleason score, fever and so on. Conclusion: Comparing with mucous surface anesthesia, local infiltration anesthesia relieved the pain better in patients undergoing TRUS guided prostate biopsy. It was more effective and safer. Trial registration: Chinese Clinical Trial Registry, Trial registration number (TRN): ChiCTR1800016424, Date of registration: 01/06/ 2018.

Morphometric study of gastric mucosa in dogs submitted to proximal gastric vagotomy, splenectomy or proximal gastric vagotomy associated with splenectomy

OBJECTIVE: The aim of the present study was to evaluate the effects of total splenectomy and proximal gastric vagotomy (PGV) isolated or associated to the vascularization of the stomach. METHODS: Twenty-eight dogs were distributed in: group A - animals undergoing laparotomy and gastric manipulation; group B - animals undergoing PGV; group C - animals undergoing PGV and splenectomy; and group D - animals undergoing splenectomy alone. All animals were sacrificed on the 7th postoperative day, and immediately followed by infusion of xanthene dye into the thoracic aorta. On the gastric mucous surface, the formation of stained areas and other areas lacking staining was measured by millimeter squares, planimetry and the computerized morphometry method. RESULTS: The formation of an area lacking in staining along the lesser gastric curvature was seen in all animals of groups B and C, which was significantly increased in group C, although in groups A and D such areas were not observed. CONCLUSION: These results showed that, in animals with splenectomy, the vascularization of the stomach was capable of perfusing the whole organ surface, but in animals with PGV alone or associated with splenectomy there was a notable decrease in blood supply throughout the area of the lesser gastric curvature, which suggests the ischemic impairment of this region.