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Intrarectal administration of lidocaine gel versus
plain lubricant gel for pain control during transrectal ultrasound-guided
extensive 10-core prostate biopsy in Hong Kong Chinese population:
prospective double-blind randomised controlled trial
SYL Leung, BBW Wong, MC Cheung,
KL Ho, FCW Lee, PC Tam
Geriatric Urology Centre, Department of Surgery, University of Hong Kong, Tung Wah Hospital, Sheung Wan, Hong Kong
OBJECTIVE. To compare the level of pain experienced
by patients during transrectal ultrasound-guided prostatic biopsy
using intrarectal 2% lidocaine gel versus plain lubricant gel.
DESIGN. Prospective double-blind randomised controlled
trial.
SETTING. Regional hospital, Hong Kong.
PATIENTS. From March 2002 to December 2003, patients
who underwent ultrasound-guided prostate biopsy at a Geriatric Urology
Centre.
MAIN OUTCOME MEASURES. Pain and discomfort scores
measured by horizontal visual analogue scales.
RESULTS. A total of 338 consecutive patients were
randomised to lidocaine gel or plain lubricant gel groups. The two
groups were statistically similar in demographic and disease characteristics.
There were no significant statistical differences in pain or discomfort
score in the lidocaine gel and plain lubricant groups—pain
score: 1.75 versus 1.79 (P=0.66) on day 0 and 0.21 versus 0.15 (P=0.97)
on day 1; discomfort score: 0.79 versus 0.77 (P=0.86) on day 0 and
0.12 versus 0.12 (P=0.76) on day 1. No major complications were
recorded in this cohort.
CONCLUSIONS. Transrectal ultrasound-guided trucut
biopsy of the prostate can be safely performed with no anaesthesia
in Chinese patients. Pain and discomfort are minimal. It was found
that 2% lidocaine gel has no statistical therapeutic or analgesic
benefit over plain lubricant gel.
Hong Kong Med J 2006;12:103-7
Key words: Anesthesia; Lidocaine; Pain measurement;
Prostatic neoplasms; Ultrasonography, interventional
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