DOI: 10.36347/sjams.2018.v06i03.057

Pages: 1087-1092

The gold standard for diagnosis of prostate cancer is biopsy of the prostate gland. Though considered a minor procedure which is relatively safe, prostate biopsy has been reported to be painful. Due to the cheaper cost, relatively lesser discomfort in administration and comparable efficacy, non-infiltrative anaesthesia represents an attractive alternative to other invasive options. The aim of this study was to determine and compare the efficacy of intrarectal lidocaine gel with oral tramadol as non-invasive options in achieving pain relief during transrectal ultrasound-guided prostate biopsy. A total of 107 patients scheduled for transrectal prostate biopsy were randomly assigned to two groups. Group 1 received 100 mg of tramadol administered orally as well as intrarectal instillation of 20mls of KY jelly (placebo lidocaine gel) before the procedure. Group 2 received 100 mg of vitamin C (placebo tramadol) with intrarectal instillation of 20 mls of 2% lidocaine prior to the procedure. The severity of pain experienced during the procedure was assessed using the numerical rating score (NRS). The mean pain scores for the tramadol and lidocaine groups during ultrasound probe insertion were 3.1±2.2 and 3.9±2.1 respectively. The mean pain scores for both groups during biopsy needle insertion were 3.9 ± 2.3 and 4.2 ± 1.9 for the tramadol and lidocaine groups respectively. The differences in mean pain scores between the groups during ultrasound probe insertion was statistically significant (P = 0.004). Oral tramadol offers significantly better pain relief during rectal ultrasound probe insertion when compared with intrarectal lidocaine gel.