M Quentin1, C Arsov2, T Ullrich1, B Valentin1, A Hiester2, D Blondin1, P Albers2, G Antoch1, L Schimmöller3. 1. Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstr. 5, D-40225, Dusseldorf, Germany. 2. Department of Urology, University Dusseldorf, Medical Faculty, D-40225, Dusseldorf, Germany. 3. Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstr. 5, D-40225, Dusseldorf, Germany. Lars.Schimmoeller@med.uni-duesseldorf.de.
Abstract
OBJECTIVES: To evaluate different analgesic techniques in MRI-guided in-bore prostate biopsy (IB-GB) regarding the influence on patient procedural experience of pain. METHODS:Two hundred fifty-two consecutive patients who had received an IB-GB either with intrarectal instillation of 2% lidocaine gel (n = 126, group A) or with periprostatic nerve block (PPNB) with 2% mepivacaine (n = 126, group B) were retrospectively included in this study. Pain scores were measured on a visual analog scale, the operating room time (ORT) was recorded for each biopsy and correlations between the parameters were analysed. RESULTS:Pain scores for IB-GB were slightly lower in group B compared with group A (2.0 ± 1.9; 2.4 ± 1.7; p = 0.02). In group A, significantly more targeted biopsy cores were acquired (group B: 5.2 ± 1.1; group A: 5.6 ± 0.8; p < 0.01). ORT was comparable and not significantly different in both groups. There was only a weak correlation between pain scores and ORT in group B (rS = 0.22; p = 0.01), but no correlation between pain scores and the number of biopsy cores or the prostate volume. CONCLUSIONS:Pain levels are generally low for MRI-guided in-bore biopsy using either PPNB or intrarectal instillation of lidocaine gel. A statistically significant, slightly lower pain score was documented for PPNB and might be preferred when the focus is analgesia. On the other hand, due to the minor difference and easier administration, intrarectal gel instillation seems to be a reasonable practice for standard analgesia for MRI-guided in-bore biopsy. KEY POINTS: • Pain levels were low for MRI-guided in-bore biopsy using either PPNB or intrarectal instillation of lidocaine gel as analgesic method. • PPNB prior to IB-GB resulted in a slightly lower pain score but required a higher effort. • Intrarectal gel anaesthesia seems to be a reasonable practice for standard analgesia for IB-GB in an outpatient setting.
RCT Entities:
OBJECTIVES: To evaluate different analgesic techniques in MRI-guided in-bore prostate biopsy (IB-GB) regarding the influence on patient procedural experience of pain. METHODS: Two hundred fifty-two consecutive patients who had received an IB-GB either with intrarectal instillation of 2% lidocaine gel (n = 126, group A) or with periprostatic nerve block (PPNB) with 2% mepivacaine (n = 126, group B) were retrospectively included in this study. Pain scores were measured on a visual analog scale, the operating room time (ORT) was recorded for each biopsy and correlations between the parameters were analysed. RESULTS:Pain scores for IB-GB were slightly lower in group B compared with group A (2.0 ± 1.9; 2.4 ± 1.7; p = 0.02). In group A, significantly more targeted biopsy cores were acquired (group B: 5.2 ± 1.1; group A: 5.6 ± 0.8; p < 0.01). ORT was comparable and not significantly different in both groups. There was only a weak correlation between pain scores and ORT in group B (rS = 0.22; p = 0.01), but no correlation between pain scores and the number of biopsy cores or the prostate volume. CONCLUSIONS:Pain levels are generally low for MRI-guided in-bore biopsy using either PPNB or intrarectal instillation of lidocaine gel. A statistically significant, slightly lower pain score was documented for PPNB and might be preferred when the focus is analgesia. On the other hand, due to the minor difference and easier administration, intrarectal gel instillation seems to be a reasonable practice for standard analgesia for MRI-guided in-bore biopsy. KEY POINTS: • Pain levels were low for MRI-guided in-bore biopsy using either PPNB or intrarectal instillation of lidocaine gel as analgesic method. • PPNB prior to IB-GB resulted in a slightly lower pain score but required a higher effort. • Intrarectal gel anaesthesia seems to be a reasonable practice for standard analgesia for IB-GB in an outpatient setting.
Entities:
Keywords:
Analgesics; Image-guided biopsy; Magnetic resonance–guided interventional procedures; Prostate cancer
Authors: Michael Quentin; Dirk Blondin; Christian Arsov; Lars Schimmöller; Andreas Hiester; Erhard Godehardt; Peter Albers; Gerald Antoch; Robert Rabenalt Journal: J Urol Date: 2014-05-24 Impact factor: 7.450
Authors: Christian Arsov; Robert Rabenalt; Michael Quentin; Andreas Hiester; Dirk Blondin; Peter Albers; Gerald Antoch; Lars Schimmöller Journal: World J Urol Date: 2015-06-09 Impact factor: 4.226
Authors: A Montoliu García; J Juan Escudero; M Fabuel Deltoro; F Serrano de la Cruz Torrijos; A Alvarez Barrera; A Amorós Torres; M Ramos de Campos; E Marqués Vidal Journal: Actas Urol Esp Date: 2010-01 Impact factor: 0.994
Authors: Christian Arsov; Robert Rabenalt; Dirk Blondin; Michael Quentin; Andreas Hiester; Erhard Godehardt; Helmut E Gabbert; Nikolaus Becker; Gerald Antoch; Peter Albers; Lars Schimmöller Journal: Eur Urol Date: 2015-06-23 Impact factor: 20.096
Authors: Lars Schimmöller; Dirk Blondin; Christian Arsov; Robert Rabenalt; Peter Albers; Gerald Antoch; Michael Quentin Journal: AJR Am J Roentgenol Date: 2016-01 Impact factor: 3.959