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.