Local anaesthetic for transrectal ultrasound-guided prostate biopsy: a prospective, randomized, double blind, placebo-controlled study.

Abstract

To evaluate the efficacy of local anaesthetic (LA) infiltration in decreasing the discomfort experienced by patients undergoing transrectal ultrasound (TRUS)-guided biopsy of prostate. 98 patients were randomized to receive 3x3ml of 1% lidocaine (n=55) or saline (n=43). The injection sites were basolaterally on each side to infiltrate the neuro-vascular bundle and one at the apex. Generally 12 systematic random biopsies were performed after which patients were asked to grade the pain of the whole procedure using a visual analogue scale ranging from 0 to 10. The LA group had a significantly lower pain score compared with placebo. The mean pain scores were 3.0 and 4.3 (p<0.001), respectively. Using an unpaired t-test, the difference between means was -1.96 to -0.51 with 95% confidence interval. There were no significant problems associated with the infiltration of either saline or LA. Local anaesthesia for TRUS biopsy is simple and well tolerated. It significantly reduces the pain associated with the procedure. We recommend its usage as a part of standard TRUS biopsy of the prostate.