Ultrasound Research Today is a free monthly online journal that collates and summarizes the latest research about Ultrasound, including details on screening, diagnosis, pregnancy, detection.

Local anesthesia in transrectal ultrasound-guided prostate biopsy: EMLA cream as a new alternative technique.

Başar H, Başar MM, Ozcan S, Akpinar S, Başar H, Batislam E

Department of Anesthesiology and Reanimation, University of Kirikkale, Kirikkale, Turkey.

OBJECTIVES: The aims of the present study were to evaluate the efficacy of eutectic mixture of local anesthetics (EMLA) cream in transrectal-guided prostate biopsy and to compare its effect with that of other injectable anesthetic procedures. MATERIAL AND METHODS: Eighty male patients with prostate-specific antigen (PSA) levels > 4 ng/ml or who had prostate nodules on digital rectal examination were randomly divided into four groups. In Group 1 (controls), prostate biopsy was performed after application of a placebo cream. In Group 2, local surface anesthesia with EMLA cream was performed 15 min before biopsy. Periprosthetic nerve blockade was performed with 1% prilocaine and 1% lidocaine in Groups 3 and 4, respectively. Pain was evaluated using a visual analog scale (VAS) after each core biopsy. In addition, blood pressure, heart rate and oxygen saturations were recorded after each biopsy and then at 5-min intervals for 15 min. RESULTS: Average VAS scores in Groups 1-4 were 5.5, 2.9, 2.4 and 2.2, respectively. There was a statistically significant difference in VAS scores between the treatment groups and the placebo group (p = 0.000). There were no statistically significant differences in VAS scores between the three treatment groups (p2-3 = 0.126, p2-4 = 0.303, p3-4 = 0.537). We detected no statistically significant differences between the groups based on the hemodynamic data (pMAP = 0.899). Moreover, these measurements did not show statistically significant changes with time in any of the groups (p > 0. 05). CONCLUSION: Intrarectal application of EMLA cream provides equal anesthesia to periprostatic nerve blockade with prilocaine and lidocaine.

Published 15 July 2005 in Scand J Urol Nephrol, 39(2): 130-4.
Full-text of this article is available online (may require subscription).

© 2004-2008 Ultrasound Research Today. All Rights Reserved.