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Clinical Research

Efficacy and safety of periprostatic nerve block combined with perineal subcutaneous anaesthesia and intrarectal lidocaine gel in transrectal ultrasound guided transperineal prostate biopsy: A Prospective Randomised Controlled Trial

Prostate Cancer and Prostatic Diseases volume 23, pages 74–80 (2020)Cite this article

Subjects

Abstract

Background

To determine the efficacy and safety of a periprostatic nerve block combined with perineum subcutaneous anaesthesia and intrarectal lidocaine gel for transrectal ultrasound-guided transperineal prostate biopsy (TPBx) through a prospective randomised controlled trial.

Methods

In total, 216 patients from May 2018 to November 2018 were randomly assigned to the experimental group and the control group at a ratio of 1:1. The experimental group received a periprostatic nerve block combined with subcutaneous perineal anaesthesia and intrarectal lidocaine gel. The control group received total intravenous anaesthesia. A visual analogue scale (VAS) score (0–10) was used to evaluate pain at different stages. The operative time, duration of hospitalisation, intraoperative vital signs, perioperative complications and clinicopathological features were recorded.

Results

The overall detection rate of prostate cancer was 40.74%, and the median Gleason score was 8 for all patients diagnosed with prostate cancer. No significant differences in terms of detection rates, Gleason scores and ISUP/WHO Grade Groups were found between the two groups (P > 0.05). The experimental group had no pain or just met the criteria for mild pain during the biopsy, which was significantly alleviated after the biopsy, and had a shorter operation time compared with that of the control group (P < 0.05). Compared with the control group, the experimental group had more stable haemodynamics and respiratory status and fewer surgical complications (P < 0.05).

Conclusions

In multiple aspects, a periprostatic nerve block combined with subcutaneous perineal anaesthesia and intrarectal lidocaine gel is a safer and more efficient approach to local anaesthesia for TPBx that can almost replace total intravenous anaesthesia and is worthwhile applying in the clinical setting.

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Acknowledgements

This work was supported by the following grants from the following organisations: the National Key R&D Programme of China (2017YFC0908004), the National Natural Science Foundation of China (No. 81001137 and No. 81874094), Hunan Provincial Natural Science Foundation of China (No. 2019JJ40484), Innovation and Entrepreneurship in South Central University project (No. 2017gczd032), and the project from Health and Family Planning Commission of Hunan Province (No. C20180105). The authors would like to thank Medbanks (Beijing) Network Technology CO., Ltd. for their assistance with data collection, data entry and data management.

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Authors and Affiliations

  1. Department of Urology, Xiangya Hospital, Central South University, Changsha City, Hunan Province, P.R. China

    Zhengtong Lv, Huichuan Jiang, Xiheng Hu, Changzhao Yang, Harripersaud Chand, Congyi Tang & Yuan Li

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  1. Zhengtong Lv
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Correspondence to Yuan Li.

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Lv, Z., Jiang, H., Hu, X. et al. Efficacy and safety of periprostatic nerve block combined with perineal subcutaneous anaesthesia and intrarectal lidocaine gel in transrectal ultrasound guided transperineal prostate biopsy: A Prospective Randomised Controlled Trial. Prostate Cancer Prostatic Dis 23, 74–80 (2020). https://doi.org/10.1038/s41391-019-0155-0

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