Assuntos
Sulfato de Bário/análise , Doenças Mamárias/diagnóstico , Mama/patologia , Calcinose/diagnóstico , Meios de Contraste/análise , Corpos Estranhos/diagnóstico , Sulfato de Bário/efeitos adversos , Doenças Mamárias/diagnóstico por imagem , Doenças Mamárias/patologia , Neoplasias da Mama/diagnóstico , Calcinose/diagnóstico por imagem , Calcinose/etiologia , Meios de Contraste/efeitos adversos , Diagnóstico Diferencial , Feminino , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/etiologia , Corpos Estranhos/patologia , Humanos , Microscopia Eletrônica de Varredura , Pessoa de Meia-Idade , RadiografiaAssuntos
Aneurisma/diagnóstico por imagem , Carcinoma Broncogênico/diagnóstico por imagem , Carcinoma Broncogênico/secundário , Neoplasias Intestinais/diagnóstico por imagem , Neoplasias Intestinais/secundário , Intestino Delgado/irrigação sanguínea , Neoplasias Pulmonares/patologia , Aneurisma/etiologia , Aneurisma/patologia , Meios de Contraste , Diagnóstico Diferencial , Dilatação Patológica , Humanos , Masculino , Pessoa de Meia-Idade , Fotomicrografia , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: To determine whether local anesthetic injection or gel reduced pain during transrectal ultrasound-guided prostate biopsies and whether there was significant difference between quadrant and apex-only anesthesia. METHODS: Between September 2001 and May 2002, 240 male patients with elevated prostate-specific antigen and (or) abnormal digital rectal examination were randomized into 1 of 4 groups: 1) transrectal lidocaine gel, 2) quadrant lidocaine injections, 3) apex-only lidocaine injections, or 4) no local anesthetic. Patients scored their pain on a numerical rating scale where 0 indicated no pain and 10 indicated worst pain. We analyzed mean and standard deviations of scores, using a 1-way analysis of variance (ANOVA) and post hoc multiple comparisons with Tukey's honestly significant difference (HSD) studentized range test to determine whether there were significant differences across the groups. RESULTS: There was no significant difference between local anesthetic gel (mean 3.1, SD 1.9) and no anesthetic (mean 3.5, SD 1.9) or between quadrant (mean 1.7, SD 1.7) and apex-only (mean 2.0, SD 1.8) local anesthetic injections. There was significant difference between quadrant injections (mean 1.7, SD 1.7) and no local anesthetic (mean 3.5, SD 1.9) and between apex-only injections (mean 2.0, SD 1.8) and no local anesthetic (mean 3.5, SD 1.9). CONCLUSION: There was significant pain reduction with local anesthetic injections but not with gel, and since there was no significant difference in efficacy between quadrant and apex-only injections, we recommend apex-only local anesthetic injections for transrectal ultrasound--guided prostate biopsies because it simplifies the injection procedure.
