Tramadol Improves Patients’ Tolerance of Transrectal Ultrasound-Guided Prostate Biopsy
Received 13 May 2006; accepted 24 October 2006.
Objectives
To evaluate the analgesic advantage of tramadol in patients undergoing transrectal biopsy of the prostate in ambulatory settings compared with topical analgesia.
Methods
A total of 77 patients scheduled for prostate biopsy were randomly assigned to receive 5% lidocaine ointment 5 mL per rectum 10 minutes before the procedure (group 1) or lidocaine ointment combined with tramadol drops 1 mg/kg per os 40 minutes before the procedure (group 2). Pain severity, main cardiorespiratory parameters, difficulty of the procedure, procedure-related side effects, and complications were analyzed.
Results
No significant respiratory or hemodynamic disturbances were observed. The pain severity, as measured on a visual analog scale, was significantly lower in group 2 (P = 0.038), and the rate of overall satisfaction with the level of analgesia was significantly greater (P = 0.027). The urologist’s assessment of “very easy” was assigned to 77.1% of procedures in group 2 compared with 54.8% of procedures in group 1 (P = 0.04). The rate of side effects in both groups was similar at 9.5% versus 11.4% (P = 0.785).
Conclusions
The combination of lidocaine per rectum with tramadol per os is a simple and safe technique providing good analgesic effect and, therefore, can be recommended for transrectal ultrasound-guided prostate biopsy.
aDepartment of Anesthesiology and Critical Care Medicine, Lady Davis Carmel Medical Center and B. & R. Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
bDepartment of Urology, Lady Davis Carmel Medical Center and B. & R. Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
Reprint requests: Irina Hirsh, M.D., Department of Anesthesiology and Critical Care Medicine, Lady Davis Carmel Medical Center, 7 Michal Street, Haifa 34362, Israel.
The present study was solely supported by the Lady Davis Carmel Medical Center, and no extra-institutional funding was accepted.
The authors affirm that no funding agreement limited their ability fairly to complete and publish their research, and that they had full control of primary data.
ABSTRACT