Korean J Urol.  2011 Mar;52(3):216-220.

Value and Safety of Midazolam Anesthesia during Transrectal Ultrasound-Guided Prostate Biopsy

• Song JH
• Doo SW
• Yang WJ
• Song YS
• Kim GW
• Ku JH
• Lee CH

Abstract

PURPOSE
Although transrectal ultrasound-guided prostate biopsy is useful for diagnosing prostate cancer, it is a painful procedure. There are many methods for providing pain relief and for treating discomfort during the procedure, but occasionally these are reported to be of limited use. We aimed to evaluate the value and safety of midazolam-induced anesthetic transrectal ultrasound-guided prostate biopsy.
MATERIALS AND METHODS
From August 2008 to December 2009, 104 male patients, who were examined with transrectal ultrasound-guided prostate 12-core biopsy, were randomly assigned to two groups. Group 1 (n=51) received ketorolac (Tarasyn(R)) 30 mg. Group 2 (n=53) was treated with midazolam (Dormicum(R)) 3 mg, which was increased to 5 mg if necessary. Immediately after the procedure, the patients were asked to rate their comfort level by using a 10-point visual analog self-assessment pain scale.
RESULTS
The pain scale in group 2 was significantly lower than that in group 1 (p<0.05). The patients assigned to group 2 experienced no side-effects from midazolam and were more satisfied than the patients in group 1 (p<0.05).
CONCLUSIONS
Midazolam anesthesia relieves pain effectively, and the patient's satisfaction is better than with conventional transrectal ultrasound-guided prostate biopsy. Midazolam-induced anesthetic transrectal ultrasound-guided prostate biopsy is useful and safe.

Keyword

Biopsy; Midazolam; Pain measurement

MeSH Terms

Anesthesia
Biopsy
Humans
Ketorolac
Male
Midazolam
Pain Measurement
Prostate
Prostatic Neoplasms
Self-Assessment
Ketorolac
Midazolam

Figure

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  FIG. 1 Pain score was evaluated with a visual analog scale. A patient is asked to rate his pain on a scale of 1-10. Rating of 1 represents mild discomfort from time to time, and a 10 is so severe that a trip to the emergency room for relief is required. The degree of pain was interpreted as none (0), mild (1-3), moderate (4-6), severe (7-9), and intolerable (10).

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  FIG. 2 Distribution of the cases in each group in regard th the degree of discomfort.

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  FIG. 3 Comparision of the groups for mean pain scale and satisfaction percentil.

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  FIG. 4 Distribution of the cases in regard to the degree of cognition Mini-Mental State Examination (MMSE).

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