Comparison of the Analgesic Effects of Intrarectal 2% and 5% Lidocaine Gel in Adult Nigerian Men Undergoing Transrectal Prostate Biopsy

Abstract

BACKGROUND: Prostate biopsy is a painful procedure. There is no generally accepted consensus among urologists on choice of analgesia. AIM: This study aims to compare the use of 2% lidocaine gel and 5% lidocaine gel on pain control in patients undergoing transrectal prostate biopsy. METHODS: This was a prospective randomized study comparing the use of 2% and 5% lidocaine gel for anesthesia during prostate biopsy. Sixty-eight patients were enrolled into the study. Using a simple random sampling technique, the patients were divided into two groups. Group A (34) patients had 2% lidocaine gel, while Group B (34) patients had 5% lidocaine gel instilled before transrectal prostate biopsy. Pain assessment was made at finger insertion, during core-needle prostate puncture, and postoperatively at 5, 10, 30, and 60 minutes for each patient using the visual analog scale. RESULTS: The two groups of patients had similar intra-operative pain control during finger insertion and at needle puncture. The mean VAS of the 2% group was 1.32 (SD ± 1.15), while those in the 5% group, it was 1.26 (SD ± 1.05), P = 0.826. The assessment for pain control at 5, 10, 30, and 60 minutes of the two groups using the mixed design repeated measures analysis of variance (ANOVA) showed that 5% group maintained a significantly better postoperative pain control at the different times F = (1,66), P < 0.001. CONCLUSION: A total of 5% lidocaine gel provides better overall postoperative analgesia compared to 2% lidocaine gel for pain control during and after digitally guided prostrate biopsy in the long term.