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ANZ J Surg. 2016 Mar;86(3):139-42. doi: 10.1111/ans.12974. Epub 2015 Feb 5.

Penthrox alone versus Penthrox plus periprostatic infiltration of local analgesia for analgesia in transrectal ultrasound-guided prostate biopsy.

Author information

1
Department of Urology, Bairnsdale Regional Health Service, Bairnsdale, Victoria, Australia.
2
Department of Urology, Alfred Health, Melbourne, Victoria, Australia.
3
Department of Anaesthesia and Perioperative Medicine, Monash University, Melbourne, Victoria, Australia.
4
Department of Anaesthesia and Perioperative Medicine, Alfred Health, Melbourne, Victoria, Australia.
5
Department of Surgery, Monash University, Melbourne, Victoria, Australia.
6
Department of Urology, Monash Health, Melbourne, Victoria, Australia.

Abstract

BACKGROUND:

The objective of this study was to compare pain intensity in patients undergoing transrectal ultrasound (TRUS)-guided biopsy of the prostate with Penthrox alone compared with Penthrox plus periprostatic infiltration of local analgesia (PILA).

METHOD:

Seventy-two subjects participated in this study after receiving appropriate education. Forty-two patients self-administered inhaled Penthrox (3 mL methoxyflurane) alone for analgesia (Group A), followed by 30 patients who self-administered Penthrox and received PILA with 5 mL of 2% lignocaine. All subjects had TRUS biopsy performed. Immediately after the procedure, patients were asked to rate their pain intensity using a numerical verbal rating scale from 0 to 10.

RESULTS:

Baseline characteristics of the two groups were similar. Patients in Group B reported significantly lower post TRUS biopsy median pain intensity of 2 (1-3) compared with Group A subjects who reported a median post TRUS biopsy pain intensity of 3 (2-5) (P = 0.014). A total of 72 men underwent TRUS-guided biopsy. All patients indicated they would be happy to have another TRUS-guided prostate biopsy in the future.

CONCLUSION:

Our study shows that Penthrox plus PILA shows promise as an efficacious and easily tolerated analgesic technique for outpatient TRUS biopsy, keeping resource use to a minimum. Planning for a multi-centre, double-blind randomized control trial comparing Penthrox plus PILA with PILA alone is presently underway.

KEYWORDS:

analgesia; biopsy; needle; pain management; prostatic neoplasms

PMID:
25655403
DOI:
10.1111/ans.12974
[Indexed for MEDLINE]

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