2219 DOES THE ADDITION OF APICAL INJECTION OF LOCAL ANESTHESIA TO BASAL INJECTION DIMINISH PAIN RELATED TO TRANSRECTAL ULTRASOUND GUIDED PROSTATE BIOPSY?
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Résumé
You have accessJournal of UrologyProstate Cancer: Detection and Screening V1 Apr 20122219 DOES THE ADDITION OF APICAL INJECTION OF LOCAL ANESTHESIA TO BASAL INJECTION DIMINISH PAIN RELATED TO TRANSRECTAL ULTRASOUND GUIDED PROSTATE BIOPSY? Ants Toi, Roy Yang, Hadas Moshonov, Sangeet Ghai, Martin O'Malley, Myles Margolis, Boriah Sreeharsha, Ravi Menezes, Neil Fleshner, and Antonio Finelli Ants ToiAnts Toi Toronto, Canada More articles by this author , Roy YangRoy Yang Toronto, Canada More articles by this author , Hadas MoshonovHadas Moshonov Toronto, Canada More articles by this author , Sangeet GhaiSangeet Ghai Toronto, Canada More articles by this author , Martin O'MalleyMartin O'Malley Toronto, Canada More articles by this author , Myles MargolisMyles Margolis Toronto, Canada More articles by this author , Boriah SreeharshaBoriah Sreeharsha Toronto, Canada More articles by this author , Ravi MenezesRavi Menezes Toronto, Canada More articles by this author , Neil FleshnerNeil Fleshner Toronto, Canada More articles by this author , and Antonio FinelliAntonio Finelli Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2394AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite basal regional local anesthetic block during prostate biopsy, many men experience pain radiating to the penis. We set out to determine if the addition of apical injection of local anesthetic to the usual basal injection decreased TRUS-guided prostate biopsy related pain, especially pain radiating to the penis. METHODS This is a prospective randomized REB approved study of consecutive men who consented to a survey of pain experienced at TRUS biopsy. We used an11 point Visual Analog Scale (VAS) ranging from 0 (no pain) to 10 (most severe pain). A 2 point difference in VAS was considered significant. Biopsy procedure consisted of DRE, probe insertion (C9-5 ICT, Philips, Bothell, WA), randomized analgesia injection of 10 mL of 1% lidocaine into the base or base+apex (22 gauge needle), scan, biopsy with 18 gauge needle gun (Bard Magnum, Covington, GA), taking core numbers as needed. Groups were assigned by opening an envelope after probe insertion and before anesthetic injection. The base (B) group received 10 mL injected at the left and right base (5 mL per side). The base+apex (BA) group received 10 mL, 6 mL at the base (3 per side) and 4 cc at the apex (2 on each side of the urethra). Pain scores and immediate and delayed complications were noted. RESULTS 178 men consented, B 89, BA 89. Baseline characteristics were similar with median values as: anxiety (3.9 vs 4.1), age (63.8 vs 65.3 years), prostate volume (44.3 vs 43.6 cc), percent with prior biopsies (42% vs 48%), needle cores taken (12 vs 13). There was no significant difference between B and BA in VAS pain scores at anesthetic injection (1.9 vs 2.2), pelvic pain (1.8 vs 1.9), penile pain (1.5 vs 1.6), degree of pain with higher (>12) numbers of cores (1.7 vs 1.6), overall pain (1.7 vs 1.7), or immediate complications (4.5% vs 2.2%). Late follow up of 67 men revealed sepsis in 2 B and 1 BA, and 1 erectile difficulty in the B group. There was no element where the VAS differed by more than 2 points. CONCLUSIONS Apical paraurethral injection of anesthetic does not significantly diminish overall pelvic or penile pain experienced during TRUS-guided prostate biopsy. There were no differences in complication rates between the two injection patterns. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e895 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ants Toi Toronto, Canada More articles by this author Roy Yang Toronto, Canada More articles by this author Hadas Moshonov Toronto, Canada More articles by this author Sangeet Ghai Toronto, Canada More articles by this author Martin O'Malley Toronto, Canada More articles by this author Myles Margolis Toronto, Canada More articles by this author Boriah Sreeharsha Toronto, Canada More articles by this author Ravi Menezes Toronto, Canada More articles by this author Neil Fleshner Toronto, Canada More articles by this author Antonio Finelli Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,172 | 0,047 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».