Application of electroacupuncture assisted local anesthesia in transperineal prostate biopsy
Objective:To preliminarily investigate the effectiveness and safety of electroacupuncture-assisted regional anesthesia in transrectal prostate biopsy.Methods:From August 1st,2022 to September 15th,2023,150 patients who underwent transperineal prostate biopsy at the Urology Center of Shuguang Hospital,Affiliated to Shanghai University of Traditional Chinese Medicine were selected as the study subjects.The patients were ran-domly divided into three groups:conventional local anesthesia group(group A,50 cases),electroacupuncture+conventional local anesthesia group(group B,50 cases),and electroacupuncture+half-dose local anesthesia group(group C,50 cases).The group A received full-dose lidocaine for peripheral nerve block anesthesia around the prostate.In group B and group C,in addition to electroacupuncture stimulation at the analgesic acupuncture points Hegu,Guanyuan,Sanyinjiao,and Shenting,full-dose and half-dose lidocaine local anesthesia were respectively administered.The completion rate of the procedure under single local anesthesia was compared among the three groups.The pain levels(measured by VAS scores)during probe insertion,local anesthesia administration,punc-ture,needle advancement,and at the end of the surgery were evaluated.The anxiety levels(measured by VAS-a scores)30 minutes before the surgery,at the start of the surgery,during the surgery,and at the end of the sur-gery,as well as the fluctuations in systolic blood pressure and heart rate,were assessed.The degree of surgical cooperation(measured by a Likert 5-point scale)and the incidence of adverse events were also recorded.Results:There were no significant differences in baseline levels among the three groups(P＞0.05).Six patients required additional anesthesia due to pain in group A.Three patients required additional anesthesia due to pain in group B.Four patients required additional anesthesia due to pain in group C.However,the difference was not statistically significant.Analyzing the patients completed the procedure under single local anesthesia,it was found that the group B and the group C had similar VAS scores at five time points:probe insertion,local anesthesia administra-tion,puncture,needle advancement,and at the end of the surgery.These scores were significantly lower than those of the group A,with statistical significance(P＜0.05).There were no significant differences in VAS-a scores among the three groups at 30 minutes before the surgery.The group B and the group C had similar VAS-a scores at the start of the surgery,during the surgery,and at the end of the surgery,and all scores were lower than those of the group A(P＜0.05).There were no significant differences in systolic blood pressure or heart rate fluctuations among the three groups at the start of the surgery.The group B and the group C had similar systolic blood pressure and heart rate fluctuations at the start of the surgery,during the surgery,and at the end of the sur-gery,and all fluctuations were lower than those of the group A(P＜0.05).The surgical cooperation level as-sessed by the primary surgeons showed no significant differences between the group B and the group C,and both groups had better cooperation levels than the group A,with statistical significance(P＜0.05).There were no sig-nificant differences in the incidence of adverse events among the three groups(P＞0.05).Conclusion:Electroacu-puncture-assisted local anesthesia is effective and safe in transrectal prostate biopsy.It can effectively reduce pa-tient pain and anxiety levels,stabilize intraoperative blood pressure and heart rate,reduce the dosage of anesthet-ics,improve the smoothness of the procedure,and ensure reliable safety.
NETL
NSTL
万方数据
