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Lidocaine Suppository Versus Lidocaine Caudal Block for Anesthesia in Patients Undergoing Transrectal Prostate Biopsy: A Randomized Controlled Study

Niger J Clin Pract. 2025 Dec 1;28(12):1443-1450. doi: 10.4103/njcp.njcp_430_25. Epub 2025 Dec 29.

ABSTRACT

BACKGROUND: Prostate biopsy remains the gold standard for the diagnosis of prostate cancer. Caudal block is one of the most common methods of anesthesia during prostate biopsy; however, lidocaine suppository can be a veritable option adapted for anesthesia in prostate biopsy.

OBJECTIVE: The aim of this study is to compare the pain levels of lidocaine suppository with lidocaine caudal block in patients undergoing transrectal finger-guided prostate biopsy.

METHODS: Sixty-six patients undergoing finger-guided prostate biopsy were randomized equally into two groups: Group A received 60 mg of lidocaine suppository and Group B received 20 ml of 1% lidocaine via caudal block before the biopsy. The patients rated the level of pain using Numerical Rating Scale (NRS) starting from the administration of anesthesia to various other points during and after the biopsy. Patients’ overall satisfaction as well as complications during the procedure were assessed for the two groups.

RESULTS: The mean pain score during biopsy was 6.27 for Group A and 5.81 for Group B, though the difference was not statistically significant. Patients experienced significantly less pain during administration of suppository lidocaine, with a mean pain score of 0.36, than during caudal block with a mean pain score of 2.81.

CONCLUSION: There is no statistically significant difference in pain during prostate biopsy between using Suppository lidocaine or lidocaine caudal block.

PMID:41459897 | DOI:10.4103/njcp.njcp_430_25