A prospective, randomized controlled study comparing lidocaine and tramadol in periprostatic nerve blockage for transrectal ultrasound-guided prostate biopsy.

OBJECTIVES: To assess the efficacy of tramadol and lidocaine in reducing pain using the periprostatic nerve block technique with a spinal needle, guided by transrectal ultrasound (TRUS) before the biopsy application.

METHODS: Of the 112 eligible candidates who were asked to participate in the study, 90 agreed and provided informed consent. These 90 men were randomized into 3 groups. Group 1 (n = 30) received lidocaine, group 2 (n = 29) received tramadol, and group 3 (n = 31) received saline solution. Within 10 minutes of biopsy procedure completion, the patients were presented with visual pain scales and asked to rate the pain. The patients also asked whether they would be to return for this procedure if it became medically necessary.

RESULTS: The postprocedural mean pain scores of lidocaine, tramadol, and placebo groups were found to be 1.73, 2.89, and 4.32, respectively. The mean pain scores were significantly lower in both the lidocaine and the tramadol groups compared with the placebo group (P <.001). In addition, statistically significant differences were found among the 3 groups regarding how willing they would be to return for the procedure if necessary.

CONCLUSIONS: In this study, we showed that the local anesthetic effect of tramadol in decreasing pain in periprostatic nerve block during TRUS-guided biopsy. The use of tramadol for pain relief in transrectal ultrasound-guided prostate biopsy is a practical, effective, and comfortable method compared with the results of the control group.