The effect of heated lidocaine gel on pain reduction during transrectal ultrasound-guided prostate biopsy: a randomized-controlled study

• Published in: International urology and nephrology Vol. 53; no. 12; pp. 2437 - 2443
• Main Authors: Jung, Joon Se, Moon, Hee Nam, Kim, Jung Im, Bae, Sang Rak, Han, Chang Hee, Park, Bong Hee
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.12.2021; Springer Nature B.V
• Subjects: Aged; Anesthesia; Anesthetics, Local - administration & dosage; Biopsy; Biopsy, Large-Core Needle; Gels; Hot Temperature; Humans; Hypersensitivity; Lidocaine; Lidocaine - administration & dosage; Local anesthesia; Male; Medicine; Medicine & Public Health; Nephrology; Pain; Pain Management - methods; Pain Measurement; Prospective Studies; Prostate; Prostatic Neoplasms - pathology; Republic of Korea; Ultrasonic imaging; Ultrasonography, Interventional; Ultrasound; Urology; Urology - Original Paper; Republic of Korea; Pain; Biopsy; Prostate; Local anesthesia
• ISSN: 0301-1623; 1573-2584
• DOI: 10.1007/s11255-021-03006-2

Purpose To determine whether intrarectal local anesthesia (IRLA) with heated lidocaine gel provides pain reduction during transrectal ultrasound (TRUS)-guided prostate biopsy. Methods We conducted a randomized-controlled study with 153 participants who underwent TRUS-guided, systematic 12-core prostate biopsy from May 2018 to June 2019. These participants were divided into three test groups. Before prostate biopsy, group A (51 patients) received no local anesthesia, group B (51 patients) received IRLA with 20 mL 2% lidocaine gel stored at room temperature, and group C (51 patients) received IRLA with heated (40 ℃) 20 mL 2% lidocaine gel. Pain was assessed using the 0–10 visual analogue scale (VAS) at three time points: VAS-1: during probe insertion, VAS-2: during biopsy, VAS-3: 30 min after the procedure. Complications during and after the procedure were evaluated. Results The mean VAS-2 score was significantly lower in group C compared to groups A and B (A, 4.6; B, 4.2; and C, 3.2; p  < 0.05). There was no significant difference among the three groups in mean VAS-1 and VAS-3 scores. No significant difference was detected in incidence of complications between the three groups. No allergic reactions to lidocaine gel were observed. Conclusion IRLA with heated lidocaine gel provides more effective pain control during TRUS-guided prostate biopsy than does conventional IRLA and no local anesthesia, without an increase of complications.