Subject(s)
Barium Sulfate/analysis , Breast Diseases/diagnosis , Breast/pathology , Calcinosis/diagnosis , Contrast Media/analysis , Foreign Bodies/diagnosis , Barium Sulfate/adverse effects , Breast Diseases/diagnostic imaging , Breast Diseases/pathology , Breast Neoplasms/diagnosis , Calcinosis/diagnostic imaging , Calcinosis/etiology , Contrast Media/adverse effects , Diagnosis, Differential , Female , Foreign Bodies/diagnostic imaging , Foreign Bodies/etiology , Foreign Bodies/pathology , Humans , Microscopy, Electron, Scanning , Middle Aged , RadiographySubject(s)
Aneurysm/diagnostic imaging , Carcinoma, Bronchogenic/diagnostic imaging , Carcinoma, Bronchogenic/secondary , Intestinal Neoplasms/diagnostic imaging , Intestinal Neoplasms/secondary , Intestine, Small/blood supply , Lung Neoplasms/pathology , Aneurysm/etiology , Aneurysm/pathology , Contrast Media , Diagnosis, Differential , Dilatation, Pathologic , Humans , Male , Middle Aged , Photomicrography , Tomography, X-Ray ComputedABSTRACT
PURPOSE: To determine whether local anesthetic injection or gel reduced pain during transrectal ultrasound-guided prostate biopsies and whether there was significant difference between quadrant and apex-only anesthesia. METHODS: Between September 2001 and May 2002, 240 male patients with elevated prostate-specific antigen and (or) abnormal digital rectal examination were randomized into 1 of 4 groups: 1) transrectal lidocaine gel, 2) quadrant lidocaine injections, 3) apex-only lidocaine injections, or 4) no local anesthetic. Patients scored their pain on a numerical rating scale where 0 indicated no pain and 10 indicated worst pain. We analyzed mean and standard deviations of scores, using a 1-way analysis of variance (ANOVA) and post hoc multiple comparisons with Tukey's honestly significant difference (HSD) studentized range test to determine whether there were significant differences across the groups. RESULTS: There was no significant difference between local anesthetic gel (mean 3.1, SD 1.9) and no anesthetic (mean 3.5, SD 1.9) or between quadrant (mean 1.7, SD 1.7) and apex-only (mean 2.0, SD 1.8) local anesthetic injections. There was significant difference between quadrant injections (mean 1.7, SD 1.7) and no local anesthetic (mean 3.5, SD 1.9) and between apex-only injections (mean 2.0, SD 1.8) and no local anesthetic (mean 3.5, SD 1.9). CONCLUSION: There was significant pain reduction with local anesthetic injections but not with gel, and since there was no significant difference in efficacy between quadrant and apex-only injections, we recommend apex-only local anesthetic injections for transrectal ultrasound--guided prostate biopsies because it simplifies the injection procedure.
