IJSR - International Journal of Scientific Research

Panda S K; Panda R; Panda S; Singh G P; Hota D

Volume : VIII, Issue : VIII, August - 2019

Periprostatic nerve block along with oral tramadol versus other forms of analgesic technique in reducing pain in patients undergoing TRUS guided prostatic biopsy: A prospective comparative study

Panda S K, Panda R, Panda S, Singh G P, Hota D

Abstract :

Objectives: Prostate biopsy accompanied by transrectal ultrasonography has been accepted as the gold standard for the diagnosis of prostate cancer. This study aims for assessment of pain in relation to TRUS–guided biopsy of prostate and Comparative assessment of pain in patient receiving oral tramadol along with periprostatic nerve block versus other form of anaesthetic modalities for reducing pain in TRUS guided prostatic biopsy. Method: A total of 60 men with abnormal PSA level and/or abnormal DRE who were undergoing prostatic biopsy for the first time were included in the study. Patients were randomized into 3 groups as patients receiving periprostatic nerve block and intraprostatic nerve block using 1% lignocaine (group 1), patients receiving periprostatic nerve block using 1% lignocaine, along with 100mg of oral tramadol (group 2) and patients receiving periprostatic nerve block alone using 1% Lignocaine (group 3). Prostate biopsies were taken in all patients following which they were assessed for pain and grading of pain was considered according to 10 point visual analog scale at the time of probe insertion, at the time of anesthesia, at the time of taking biopsy and after 30 min of completion of procedure. Result: Group 1 recorded the minimum mean pain score during prostate biopsy which was significantly lower than group 3. Group 2 recorded significantly lower pain score at time of probe insertion and at anesthetic needle insertion than group 1. The group–2 also recorded significantly lower pain score at time of probe insertion, anesthesia and biopsy but not at 30 min post–biopsy than the control group. There is no significant difference in pain score at time of biopsy between group 1 and group 2. So, oral tramadol provides significant analgesia at all times except post procedure time. No major complications were reported with periprostatic block and intraprostatic nerve block. Conclusion: At the end of the study it was observed that patient group which received periprostatic nerve block (1% lignocaine) with 100mg oral tramadol as a modality of anesthesia (i.e. Group 2), provides significant analgesia at all times expect post procedure time with added advantage of oral intake. We recommend the use of periprostatic block (1% lignocaine) with 100mg of oral tramadol in transrectal ultrasound guided prostate biopsies, because it is inexpensive, safe, easy to perform in outpatient clinics, and an effective anesthetic method.