A Prospective Analysis of the Efficacy and Safety of Caudal Block for Transrectal Ultrasound Guided Prostate Biopsy in Patients With Anorectal Disorders

Abstract

In this study, the efficacy and safety of the caudal block technique for transrectal ultrasonography-guided biopsy (Trus-guided biopsy) in patients with anorectal problems were investigated. A total of 31 consecutive patients with anal-rectal problems underwent prostate needle biopsy. All patients included in the study were examined by an experienced general surgeon, and the presence of anorectal problems was confirmed. The majority of patients (61%) were referred from the outer center to our clinic beca use a biopsy could not be performed due to severe pain felt during rectal probe insertion despite local anesthesia (topical prilocaine or lidocaine cream). A 12-core biopsy protocol was applied to all patients under the caudal block. Pain perception was se parately assessed during caudal anesthesia, probe insertion, and sampling stages using a visual analog scale (VAS) score. The mean age was 64.1 ± 9.1 years. The mean VAS score during caudal anesthesia was 1.8 ± 0.81. At probe insertion, the mean VAS score was 1,44 ± 012. During the needle penetration into prostate tissue and sampling, the mean VAS score was 2.44± 013. All of the patients did not state any bothersome pain at any stage. We did not find any complications related to the anesthesia method. Topical creams and/or periprostatic nerve block (PNB) do not provide adequate analgesia in patients with anorectal disorders undergoing Trus-guided biopsy. Caudal block technique can be performed effectively and reliably in this selected patient group. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.