Local anaesthetic for transrectal ultrasound-guided prostate biopsy: A prospective, randomized, double blind, placebo-controlled study

Objective: To evaluate the efficacy of local anaesthetic (LA) infiltration in decreasing the discomfort experienced by patients undergoing transrectal ultrasound (TRUS)-guided biopsy of prostate. Patients and methods: 98 patients were randomized to receive 3 x 3 ml of 1% lidocaine (n = 55) or saline (n = 43). The injection sites were basolaterally on each side to infiltrate the neuro-vascular bundle and one at the apex. Generally 12 systematic random biopsies were performed after which patients were asked to grade the pain of the whole procedure using a visual analogue scale ranging from 0 to 10. Results: The LA group had a significantly lower pain score compared with placebo. The mean pain scores were 3.0 and 4.3 (p < 0.001), respectively. Using an unpaired t-test, the difference between means was -1.96 to -0.51 with 95% confidence interval. There were no significant problems associated with the infiltration of either saline or LA. Conclusion: Local anaesthesia for TRUS biopsy is simple and well tolerated. It significantly reduces the pain associated with the procedure. We recommend its usage as a part of standard TRUS biopsy of the prostate. (C) 2003 Elsevier Science B.V. All rights reserved.