Display options
Cite
Imani F, Moghaddam Y, Shariat Moharari R, et al. Intrarectal Lidocaine-Diltiazem-Meperidine Gel for Transrectal Ultrasound Guided Prostate Biopsy. Anesth Pain Med. 2015;5(3):e22568doi: 10.5812/aapm.5(3)2015.22568.
Imani, F., Moghaddam, Y., Shariat Moharari, R., Etezadi, F., Khajavi, M. R., & Hosseini, S. R. (2015). Intrarectal Lidocaine-Diltiazem-Meperidine Gel for Transrectal Ultrasound Guided Prostate Biopsy. Anesthesiology and pain medicine, 5(3), e22568. https://doi.org/10.5812/aapm.5(3)2015.22568
Imani, Farsad, et al. "Intrarectal Lidocaine-Diltiazem-Meperidine Gel for Transrectal Ultrasound Guided Prostate Biopsy." Anesthesiology and pain medicine vol. 5,3 (2015): e22568. doi: https://doi.org/10.5812/aapm.5(3)2015.22568
Imani F, Moghaddam Y, Shariat Moharari R, Etezadi F, Khajavi MR, Hosseini SR. Intrarectal Lidocaine-Diltiazem-Meperidine Gel for Transrectal Ultrasound Guided Prostate Biopsy. Anesth Pain Med. 2015 Jun 22;5(3):e22568. doi: 10.5812/aapm.5(3)2015.22568. eCollection 2015 Jun. PMID: 26161317; PMCID: PMC4493733.
Copy Download .nbib Format: NLM
Share it on

Anesth Pain Med. 2015 Jun 22;5(3):e22568. doi: 10.5812/aapm.5(3)2015.22568. eCollection 2015 Jun.

Intrarectal Lidocaine-Diltiazem-Meperidine Gel for Transrectal Ultrasound Guided Prostate Biopsy.

Anesthesiology and pain medicine

Farsad Imani, Yasaman Moghaddam, Reza Shariat Moharari, Farhad Etezadi, Mohammad Reza Khajavi, Seyed Reza Hosseini

Affiliations

  1. Department of Anesthesia, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  2. Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

PMID: 26161317 PMCID: PMC4493733 DOI: 10.5812/aapm.5(3)2015.22568

Abstract

BACKGROUND: TRUS-guided needle biopsy of the prostate gland is the current standard method used for diagnosis of prostate cancer. Pain control during this procedure is through the use of i.v. sedation or local anaesthetic (LA), depending on clinician preference.

OBJECTIVES: The aim of this study was to evaluate the effectiveness of intrarectal lidocaine, lidocaine-diltiazem and lidocaine-meperidine-diltiazem gel for anesthetizing transrectal ultrasound guided prostate biopsy.

PATIENTS AND METHODS: In a randomized double-blind clinical trial, 100 consecutive patients were divided into three groups. The patients received one of the gels before transrectal ultrasound guided prostate needle biopsy: group A, intrarectal and perianal lidocaine, gel 1 g; group B, intrarectal lidocaine gel, 1 g, + perianal diltiazem, 1 g; group C, intrarectal lidocaine gel, 1 g, + meperidine, 25 mg, and perianal diltiazem, 1 g. Visual analog pain scale was used to estimate pain during probe insertion and biopsy. Heart rate and blood pressure during probe insertion and biopsy were recorded too.

RESULTS: The mean of visual analog pain scale was 4.5 in group A, 3.5 in group B, and 2.0 in group C during probe insertion (P value = 0.01). The mean of visual analog pain scale was 5.1 in group A, 3.5 group B, and 2.5 in group C during biopsy (P value = 0.001). The groups were comparable for patients' age, weight, serum prostate-specific antigen (PSA), and prostate size (P > 0.05). No side effects of meperidine and lidocaine including drowsiness, dizziness, tinnitus and light-headedness or requiring assistance for activity were noted.

CONCLUSIONS: Lidocaine-meperidine-diltiazem gel provides significantly better pain control than lidocaine-diltiazem gel and lidocaine gel alone during transrectal ultrasound guided prostate biopsy and probe insertion. This mixture gel is safe, easy to administer and well accepted by patients.

Keywords: Benign Prostatic Hyperplasia; Pain

References

  1. Anesthesiology. 2000 Jan;92(1):147-55 - PubMed
  2. BJU Int. 2004 Jun;93(9):1216-7 - PubMed
  3. Colorectal Dis. 2011 Mar;13(3):328-32 - PubMed
  4. Dis Colon Rectum. 2000 Oct;43(10):1359-62 - PubMed
  5. J Urol. 1989 Jul;142(1):71-4; discussion 74-5 - PubMed
  6. J Urol. 2004 Feb;171(2 Pt 1):730-3 - PubMed
  7. J Urol. 2009 Feb;181(2):585-91; discussion 591-3 - PubMed
  8. BJU Int. 2001 Oct;88(6):540-4 - PubMed
  9. J Endourol. 2010 Dec;24(12):2033-6 - PubMed
  10. Colorectal Dis. 2002 Nov;4(6):430-5 - PubMed
  11. Nephrourol Mon. 2012 Summer;4(3):560-4 - PubMed
  12. BJU Int. 2009 May;103(9):1195-8 - PubMed
  13. BJU Int. 2005 Dec;96(9):1264-7 - PubMed
  14. Clin Geriatr Med. 2001 Aug;17(3):433-56, v-vi - PubMed
  15. Iran J Radiol. 2012 Jun;9(2):67-70 - PubMed
  16. Lancet. 2004 Jun 5;363(9424):1840-1 - PubMed
  17. Nephrourol Mon. 2013 Jul 1;5(3):792-800 - PubMed
  18. Anaesthesia. 2007 Jun;62(6):581-5 - PubMed

Publication Types