Transrectal ultrasound-guided biopsy (TUSPB) is the standard method of diagnosis for prostate cancer, and although it is well tolerated by some patients, it presents a discomfort rate of 65 to 90%, which may be associated with pain. For convenience, it is agreed that a method of analgesia and sedation is necessary. For this purpose, this study aimed to evaluate the impact of inhalation of a 50-50% N2O-O2 gas mixture on pain intensity in these patients.
Randomized, double-blinded clinical trial, conducted at Antônio Pedro University Hospital (Hospital Universitário Antônio Pedro), Niterói, RJ, Brazil, containing two groups of 42 patients: a control (C) group, which received 100% oxygen inhalation, and a nitrous oxide (NO) group, which received inhalation of the 50-50% N2O-O2 mixture, self-administered during TUSPB. The pain intensity and degree of satisfaction were evaluated through a visual analogue scale (VAS), as was the frequency of adverse events.
Eighty-four patients were included in the study, with 42 in each group. The mean pain intensity was lower in the NO group than in the C group [2.52 (0-10) vs 5.95 (0-10), p < 0.001], and the degree of satisfaction was higher in the NO group than in the C group (8.14 vs. 4.69, p < 0.001). The adverse effects were somnolence, dizziness, nausea, vomiting, discomfort and euphoria without differences between the groups.
The 50-50% N2O-O2 mixture was effective in reducing pain intensity and increasing the degree of satisfaction in TUSPB, with tolerable side effects.
PloS one. 2018 Apr 27*** epublish ***
Gabriel da Silva Cazarim, Nubia Verçosa, Leonel Carneiro, Rachel Pastor, Elizabeth Fernandes Vaz da Silva, Louis Barrucand, Ismar Lima Cavalcanti
Department of Anesthesiology, Federal Fluminense University, University hospital Antonio Pedro, Niterói, Rio de janeiro, Brazil., Department of Anesthesiology, Federal University of Rio de Janeiro, University hospital Clementino Fraga Fihlo, Rio de Janeiro, Rio de Janeiro, Brazil., Department of Statistic, Federal University of Rio de Janeiro, University hospital Clementino Fraga Fihlo, Rio de Janeiro, Rio de Janeiro, Brazil.