前列腺神经阻滞术在经直肠前列腺穿刺活检术中的应用

Application of Transrectal Ultrasound Guided Prostatic Nerve Blockade in Transrectal Prostate Biopsy

目的评价经直肠超声引导下的前列腺神经阻滞术在经直肠前列腺穿刺活检术中的镇痛效果。方法73例拟接受经直肠超声引导下 13点前列腺系统穿刺活检术的患者随机分为A、B两组。在经直肠超声引导下 ,于前列腺基底部 ,左、右两侧精囊与前列腺交接处进行注射。A组患者左、右两侧分别注射 1%利多卡因 5ml,B组患者注射生理盐水 5ml。采用视觉模拟评分 (VAS)评估患者在穿刺活检中的疼痛程度。结果两组患者平均VAS分别为 1.1分和 5 .9分 ,差异具有高度显著性 (t =4 .81,P <0 .0 1)。A组患者未出现局麻药的不良反应。结论经直肠超声引导下的前列腺神经阻滞术可明显减轻患者在前列腺穿刺活检术中的疼痛和不适 ,是一种安全、有效的局麻方法 ,值得临床推广应用。

ObjectivesTo evaluate the analgesic efficacy and safety of transrectal ultrasound guided prostatic nerve blockade during transrectal prostate biopsy.MethodsSeventy three patients requiring systematic 13 cores biopsy in the prostate were randomly divided into two groups: Group A (37 cases) received an injection of 5ml 1% lidocaine into the prostatic neurovascular bundles on each side under transrectal ultrasound guidance; Group B(36 cases) received 5ml of 0.9% normal saline at the same way. The intensity of pain during biopsy was recorded and assessed using a 10 point linear visual analogue pain scale(VAS) immediately after this procedure. ResultsThe mean pain scores of Group A during transrectal prostate biopsy were significantly lower than those of Group B(1.1±0.6 versus 5.9±3.1,t=4.81,P<0.01). No patient in either group felt any adverse response from the local injection . ConclusionTransrectal ultrasound guided prostate nerve blockade can obviously relieve pain and improve discomfort during biopsy. It is a safe and efficacious method to produce satisfactory local anesthesia, worthy of routine clinical application.