Gel combination offers pain relief in prostate biopsy

  • Imani F & al.
  • Anesth Pain Med
  • 1 Dec 2018

  • curated by Craig Hicks
  • Clinical Essentials
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Takeaway

  • Lidocaine gel combined with topical fentanyl reduces pain from prostate biopsy more effectively than lidocaine alone, without the adverse effects and cost of a peripheral nerve block.

Why this matters

  • Lidocaine gel alone often does not provide adequate analgesia during prostate biopsy.

Study design

  • This double-blind randomized clinical trial examined patients undergoing prostate biopsy (N=96) randomly assigned to either a treatment group receiving intrarectal lidocaine gel (2%) 50 g or an intervention group receiving lidocaine gel (2%) 50 g and fentanyl gel 50 µg.
  • Researchers recorded patient visual analog scale (VAS) scores during the biopsies and monitored BP, heart rate, and patient level of consciousness.
  • Funding: None disclosed.

Key results

  • The mean VAS score was significantly better in the intervention group (3.0±2) than in the treatment group (5.1±2; P<.001>
  • Both groups had similar levels of consciousness after biopsy (P=.358).
  • Mean BP and heart rate before and during the prostate biopsy were also similar for both groups.

Limitations

  • The study was single-center with a small sample size.

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