Prilocaine Irrigation for Pain Relief Following Transurethral Resection of the Prostate (TURP).

Sakarya University Education and Research Hospital, Urology, Beşköprü M. Girne Caddesi Beyaz Kent Sitesi D4 , Sakarya, Turkey, 54100
Journal of endourology / Endourological Society (Impact Factor: 2.1). 04/2013; 27(7). DOI: 10.1089/end.2013.0001
Source: PubMed

ABSTRACT Abstract Aim: This study aimed to examine the effect of postoperative addition of a local anaesthetic agent to irrigation fluid on the alleviation or prevention of pain following transurethral resection of the prostate (TURP). Patients and Methods: This prospective, double blind, placebo-controlled study included 50 patients aged 50-87 years. The patients were randomized into 2 groups. As each patient began to experience postoperative pain after spinal anaesthesia wore off 30 cc of 2% prilocaine was injected into irrigation solution bags and the bladder was irrigated (prilocaine group). The irrigation solution used in the control group was prilocaine-free. Visual analog scale (VAS) scoring was used to assess the severity of pain. Bladder irrigation in all patients was discontinued 1 day post surgery. Results: There wasn't a statistical difference in surgical parameters between the 2 groups. All patients in the prilocaine group were satisfied with the analgesic efficacy of prilocaine, except for 2 (8%). The mean number of irrigation solution bags (3000 cc) used for each patient in the prilocaine group was 7.04±1.2. Prilocaine-related side effects were not observed. Conversely, all but 2 patients in the control group developed pain. The mean number of irrigation solution bags used for each patient in the control group was 7.6±1.8. Mean VAS pain score was 0.35±0.12 and 5.10±3.26 in the prilocaine and control groups, respectively (p <0.001). Conclusion: Prilocaine solution safely alleviated postoperative pain in the patients that underwent TURP. The use of continuous bladder irrigation with a diluted prilocaine solution consistently decreased the need for parenteral analgesics. Keywords: Pain management; TURP; prilocaine; bladder irrigation.