Korean J Urol.  2011 Jul;52(7):452-456.

Effect of Oral Administration of Acetaminophen and Topical Application of EMLA on Pain during Transrectal Ultrasound-Guided Prostate Biopsy

• Kim S
• Yoon BI
• Kim SJ
• Cho HJ
• Kim HS
• Hong SH
• Lee JY
• Hwang TK
• Kim SW

Abstract

PURPOSE
Transrectal ultrasound-guided prostate biopsy is the procedure of choice for diagnosing prostate cancer. We compared with pain-relieving effect of acetaminophen, a known drug for enhancing the pain-relieving effect of tramadol, and eutectic mixture of local anesthetics (EMLA), a local anesthetic agent, with that of the conventional periprostatic nerve block method.
MATERIALS AND METHODS
This was a prospective, randomized, single-blinded study. A total of 430 patients were randomly assigned to three groups. Group 1 received a periprostatic nerve block with 1% lidocaine, group 2 received acetaminophen 650 mg, and group 3 received EMLA cream for pain control. All patients were given 50 mg of tramadol intravenously 30 minutes before the procedure. At 3 hours after completion of the procedure, the patients were asked to grade their pain on a horizontal visual analogue scale (VAS). The patients were also asked whether they were willing to undergo future biopsy if required.
RESULTS
There were no significant differences between the three groups in terms of age, prostate-specific antigen, prostate size, or numbers of biopsy cores. The pain scores for groups 2 and group 3, which were 3.47+/-1.92 and 3.50+/-1.36, respectively, were similar and were significantly lower than that of group 1, which was 5.24+/-2.07.
CONCLUSIONS
Acetaminophen and EMLA cream with intravenous injection of tramadol are safe, easy, and effective methods of controlling pain during the procedure. These methods were more effective for pain relief than was the conventional periprostatic nerve block method.

Keyword

Acetaminophen; Biopsy, needle; EMLA; Pain; Prostate

MeSH Terms

Acetaminophen
Administration, Oral
Anesthetics, Local
Biopsy
Biopsy, Needle
Humans
Injections, Intravenous
Lidocaine
Nerve Block
Prilocaine
Prospective Studies
Prostate
Prostate-Specific Antigen
Prostatic Neoplasms
Tramadol
Acetaminophen
Anesthetics, Local
Lidocaine
Prilocaine
Prostate-Specific Antigen
Tramadol

Figure

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  FIG. 1 Pain scale (0-10 visual analogue pain scale).

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