Uro-4. Impact of age, number of biopsies and prostate volume on the outcome of local anesthesia in transrectal ultrasound-guided prostate needle biopsy.Transrectal ultrasound (TRUS TRUS Transrectal ultrasonography, see there )-guided prostate needle biopsy needle biopsy
Removal of a specimen for biopsy by aspirating it through a needle or trocar that pierces the skin or the external surface of an organ and continues into the underlying tissue to be examined. Also called aspiration biopsy. is the standard method for diagnosis of prostate cancer prostate cancer, cancer originating in the prostate gland. Prostate cancer is the leading malignancy in men in the United States and is second only to lung cancer as a cause of cancer death in men. . Periprostatic block is commonly used for local anesthesia Anesthesia, Local Definition
Local or regional anesthesia involves the injection or application of an anesthetic drug to a specific area of the body, as opposed to the entire body and brain as occurs during general anesthesia. during this procedure. The purpose of this study is to evaluate the factors that affect patients' subjective pain score. This is a retrospective study of 274 consecutive patients from the Veterans Administration Hospital in New Orleans, LA, who underwent TRUS prostate needle biopsy from April 2002 to June 2003 for either elevated PSA (Professional Services Automation) An information system designed to organize, track and manage all opportunities, work, resources, costs, revenues and invoices to improve the productivity and efficiency of the workforce. or abnormal digital rectal exam. Periprostatic block anesthesia injected under TRUS guidance with 10 cc 1% lidocaine lidocaine /li·do·caine/ (li´do-kan) an anesthetic with sedative, analgesic, and cardiac depressant properties, applied topically in the form of the base or hydrochloride salt as a local anesthetic; also used in the latter form as a was administered. Subjective pain scores were obtained from the patients immediately following biopsy. This was measured using the visual analog pain scale. On analysis, patients were separated into groups based on age (40-49, 50-59, 60-69, >70), TRUS volume (<30 cc, 30-50 cc, >50 cc), and number of biopsy specimens (<10 vs >10), and the pain scores of the groups were compared. Collective mean pain score was 2.99. There were no biopsy- or anesthesia-related complications. There was no significant difference in pain score between prostate size groups. There was no difference in pain score between patients having <10 and >10 biopsy cores. There was a significant difference between age groups when separately comparing the 50-59 group (mean=2.9, SE 0.2) and the 60-69 group (mean=3.3, SE 0.2) to the >70 group (mean=2.3, SE 0.3) (P < 0.05). There was no significant difference when comparing the 50-59 group to the 60-69 group. Periprostatic anesthesia for TRUS prostate needle biopsy is a safe practice, which has been shown to reduce patient perceived pain. The number of cores taken does not affect perceived pain, thus allowing for more cores to be comfortably taken without worry of increasing patient discomfort. Prostate gland size does not affect the efficacy of periprostatic anesthesia. Overall, with advancing age, there is a decrease in the perceived pain felt during the biopsy.
Michael E. Woods, Christopher Wolter, J. Ryan Glass, Trinity J. Bivalacqua, Krishnarao Moparty, and Rodney Davis. Tulane University School of Medicine History
Founded in 1834, Tulane University School of Medicine is the 15th oldest medical school in the United States. Today the medical school is but one part of the Tulane University Health Sciences Center, which includes the School of Medicine, the Tulane University Hospital , New Orleans, LA.