Published in BJU Int. 2014 Jul 21.
Authors: Jindal T et al
To assess the role of pelvic plexus block (PPB) in reducing pain during transrectal ultrasound (TRUS) guided prostate biopsy, in comparison with the conventional periprostatic nerve block (PNB).
MATERIALS AND METHODS:
A prospective, double blinded observational study was conducted with the patients being randomized into three groups. Group-1 (47 patients) received intrarectal local anaesthesia (IRLA) with 10 ml of 2% lignocaine jelly along with pelvic plexus block (PPB) with 2.5 ml of 2% lignocaine injection bilaterally. Group-2 (46 patients) received IRLA with periprostatic nerve block (PNB). Group-3 (46 patients) received only IRLA without any type of nerve block. The patients were requested to rate the level of pain from 0 to 10 on visual analogue scale (VAS) at two time points – VAS-1: during biopsy procedure and VAS -2: 30 minutes after the procedure.
Mean age of the patients, mean volume of the prostates and mean serum PSA values were comparable among these three groups. The mean pain score during the biopsy was significantly less in PPB group (mean score of 2.91, range 2-4), compared to PNB group (mean score of 4, range 3-5), and both these groups were superior to no nerve block group (mean score of 5.4, range 3-7). There was no significant difference between the mean pain scores, 30 minutes after the procedure, among the three groups with the mean score being 2.75 (range 2-4), 2.83 (range 2-4) and 2.85 (range 2-4), respectively.
Pelvic plexus block (PPB) is superior to conventional periprostatic nerve block (PNB) in term of pain control during TRUS biopsy and both are in turn superior to no nerve block.