Periprostatic Lidocaine Infiltration Versus Transrectal Lidocaine Gel For Local Anaesthesia In Transrectal Ultrasound Guided Prostate Biopsy

Management of pain plays an important role during prostate biopsy. Various types of management of pain plays an important role during prostate biopsy. Various types of anaesthetic methods have been used. The present study aimed to compare the efficacy and complication rate between periprostatic lidocaine infiltration and transrectal lidocaine gel in transrectal ultrasound guided prostate biopsy. All prostate biopsy patients were included except those with lidocaine, allergy, haemorrhagic diathesis, anticoagulation therapy, the inability to rate a visual analogue scale and inability to obtain consent. They were randomized into two groups. Group 1 received 20ml 2% transrectal lidocaine gel. Group 2 received 5ml 1% lidocaine infiltration for each periprostatic nerve block with 23-gauge spinal needle. After three minutes, prostate biopsy was performed with an 18 gauge 7-inch spring-loaded biopsy gun. Six biopsies were taken for each lobe. Pain during probe insertion, biopsy and immediately after the procedure was assessed using the Visual Analogue Scale. Any complication immediately after procedure, one day or after one week, was recorded. Mean pain score was lower after periprostatic lidocaine infiltration compared to transrectal lidocaine gel (3.1 + 1.9 versus 4.9 + 2.4, p = 0.027). There was no statistically significant difference in the complication rate. Transrectal ultrasound prostate biopsy using periprostatic lidocaine infiltration provides better anaesthesia as compared to the transrectal lidocaine gel application with no significant difference in complication. Thus, the use of periprostatic lidocaine infiltration in TRUS guided prostate biopsy is recommended.

Comparisons of Vascular Pain during Intravenous Administration: Thiopental and Propofol / 대한마취과학회지

BACKGROUND: Even though propofol having many clinical merits, a vascular pain during intravenous administration of it could maKe us choose other induction agents. One of many METHODS to decrease vascular pain, the use of propofol preserved in a cold temperature (1 4degeesC) was introduced and Known to be effective. The purpose of this study was to compare vascular pain of cold propofol with that of thiopental as induction agents. METHODS: Sixty adult patients for elective surgery were randomly assigned to the two groups according to receiving thiopental (Group I, n = 30) or propofol (Group II, n = 30), then they were divided randomly into two subgroups according to the selection of vascular size; vein on the dorsum of hand or antecubital fossa. As an induction agent, 2.5% thiopental (5 mg/Kg) or cold 1% propofol (2 mg/Kg) were given intravenously during 40 sec. The severity of vascular pain (classified by 4 points verbal category system) and the incidences of pain were compared according to the induction agents and the selection of vascular size. The incidences of moderate to severe pain according to the selection of induction agents were compared. RESULTS: There was no significant difference in the severity, incidence of pain or incidence of moderate to severe pain in both groups, There was no significant difference in the incidence of pain according to the vascular size. CONCLUSIONS: As cold propofol was given slowly (during 40 sec), the vascular pain was not significant to hinder the selection of propofol as an induction agent compared with that of thiopental.

The Effect of Ketorolac on Propofol Injection Pain / 대한마취과학회지

BACKGROUND: Many strategies to reduce pain during propofol injection have been investigated. Inhibitors of cyclooxygenase are frequently used to provide post operative pain relief in patients undergoing minor gynecologic surgery. Therefore, in this study, we have investigated whether ketorolac injected intravenously reduces pain during propofol injection. METHODS: Fifty healthy female patients scheduled for minor gynecological surgery were randomly allocated to one of four groups. All patients were inserted 20 G Angiocatheter into the veins on the dorsum of the hands. After applying an arm tourniquet at an inflation pressure of 40-45 mmHg, the control group received 2 ml of 0.9% saline, and those in groups I, II, and III received ketorolac 0.5, 0.75, and 1.0 mg/kg mixed with 2 ml of 0.9% saline respectively. The tourniquet was released 2 minutes later. 2 mg/kg of 1% propofol bolus was then injected with an infusion pump intravenously. After 50 mg of propofol were injected, patients were assessed for visual analogue scale (VAS) scores and pain grades. RESULTS: VAS scores during propofol injection diminished significantly in group II (0.75 mg/kg ketorolac) and group III (1 mg/kg ketorolac) compared with the control (saline) group. CONCLUSIONS: Pretreatment with intravenous ketorolac more than 0.75 mg/kg during the 2 minutes tourniquet time can reduce pain elicited by profofol injection.

Pain on Injection of Propofol: Comparison of the Methods of Alleviation / 대한마취과학회지

BACKGROUND: Various kinds of methods had been tried to reduce pain on injection of propofol. In this study, the effect of lidocaine pretreatment and that of temperature controlled injections were compared and evaluated its clinical utility. METHODS: One hundred and twenty patients were randomly allocated into 4 groups after permission. Room temperature propofol was used as induction agent in group P,. In group C, cooling (4 degrees C) propofol was used and warming propofol (37 degrees C) in group H. And room temperature propofol following lidocaine (1 mg/kg) was used in group L. Injection dosage of propofol was 2 mg/kg and injection speed was 2 ml/sec in all groups. In each patients, pain score and visual analog scale were measured and tested by ANOVA or Kruskal-Wallis test. RESULTS: There were no statistical significant difference in pain score among the 4 groups. But in visual analog scale analysis, group L markedly reduced values than the other groups by statistically significant manner (in Duncan grouping). CONCLUSION: The alleviating effect of lidocaine pretreatment on painful injection was better than that of changing temperature of propofol itself. More over effectiveness, in view of simplicity, we recommend lidocaine pretreatment.