Estudio comparativo entre la eficacia analgésica y seguridad de la meperidina intravenosa frente a la infiltración periprostática con lidocaína en biopsias transrectales de próstata
Comparative study between analgesic efficacy and safety of meperidine compared with lidocaine periprostatic infiltration in transrectal ultrasound guided prostate biopsy
Sátur Luján marcoa,1
, Vanessa Bango garcíaa, Salvador Arlandis guzmána, Carlos Di capua sacotoa, Pilar Bahílo mateua, Marta Trassierra villaa, Miguel Ramírez backhausa, Juan F. Jiménez cruza
Autor para correspondencia
slujanmarco@comv.es
Correspondencia autor: Dr. S. Luján Marco Servicio de Urología. Hospital Universitario La Fe Avda. Campanar, 21 - 46009 Valencia. Tel.: 963 862 700
Correspondencia autor: Dr. S. Luján Marco Servicio de Urología. Hospital Universitario La Fe Avda. Campanar, 21 - 46009 Valencia. Tel.: 963 862 700
a Servicio de Urología. Hospital Universitario La Fe Valencia
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"apellidos" => "Jiménez cruz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicio de Urología. Hospital Universitario La Fe Valencia" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia autor: Dr. S. Luján Marco Servicio de Urología. Hospital Universitario La Fe Avda. Campanar, 21 - 46009 Valencia. Tel.: 963 862 700" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Comparative study between analgesic efficacy and safety of meperidine compared with lidocaine periprostatic infiltration in transrectal ultrasound guided prostate biopsy" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-10-01" "fechaAceptado" => "2008-11-01" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec88771" "palabras" => array:4 [ 0 => "Biopsia de Próstata" 1 => "Meperidina" 2 => "Infiltración periprostática" 3 => "Lidocaína" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec88772" "palabras" => array:4 [ 0 => "Prostate biopsy" 1 => "Meperidine" 2 => "Periprostatic infiltration" 3 => "Lidocaine" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluar la eficacia de la analgesia intravenosa con meperidina frente a la infiltración del plexo periprostático con lidocaína, y seguridad de la anestesia local periprostática.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo aleatorizado con 100 pacientes sometidos a primera o segunda biopsia de próstata. Distribuimos a los pacientes en dos grupos; grupo A (50 pacientes) al que se le administra 50 mg de meperidina intravenosa y grupo B (50 pacientes) que reciben 5 mL de lidocaína al 2% en el ángulo prostatoseminal. El dolor fue evaluado mediante la Escala Analógico Visual (VAS) y un cuestionario a cerca del impacto emocional de la prueba. La seguridad del procedimiento se obtuvo mediante cuestionario telefónico sobre las complicaciones aparecidas tras la biopsia. Para el análisis estadístico se uso el test de chi cuadrado, la t de Student y test no paramétrico de Kruskal-Wallis.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La mediana de edad fue 66 años (47-80) siendo ambos grupos homogéneos respecto a: PSA, volumen prostático, número de cilindros y nivel de estudios, sin diferencias significativas. Se trató de una primera biopsia en 74 pacientes (74%) y 26 (26%) de una segunda. El número medio de cilindros fue de 10,9±2. La puntuación media del VAS para el grupo A fue 3,6±1,8 frente a 3,2±2 del grupo B sin diferencias significativas (p>0,05). Si comparamos el dolor con la introducción del transductor (grupo A 3,9±1,9 / grupo B 4,3±2,2) frente a la toma de cilindro (grupo A 3,6±1,8/grupo B 3,2±22) sí encontramos diferencias significativas (p<0,05). No se observan diferencias ente los datos obtenidos con el test de impacto emocional, la edad y el nivel de estudios frente al dolor producido por la prueba. Respecto al número de cilindros obtenidos tampoco existen diferencias (p>0,05). Aparecieron complicaciones en 12 pacientes (12%); 5 en el grupo de meperidina frente a 7 en el de lidocaína sin observar diferencias entre ambos.</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El bloqueo del plexo periprostático con lidocaína no ofrece ventajas analgésicas respecto a la meperidina, a pesar de que se trata de un método seguro que no aumenta el número de complicaciones. El paso del transductor transrrectal produce más dolor que la propia toma de los cilindros.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To assess the efficacy of intravenous analgesia with meperidine compared to periprostatic plexus infiltration with lidocaine, and safety of periprostatic local anesthesia.</p> <span class="elsevierStyleSectionTitle">Materials and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A prospective randomized study with 100 patients undergoing first or second prostate biopsy. We distribute patients in two groups, group A (50 patients) which was administered 50 mg of intravenous meperidine and group B (50 patients) receiving 5 mL of lidocaine 2% in the angle between prostate and seminal vesicles. Pain was assessed by Visual Analog Scale (VAS) and a questionnaire about the emotional impact. Procedure safety was obtained by telephone questionnaire about prostate biopsy complications. The statistical analysis used was chi square test, Student’s t test and Kruskal-Wallis no parametric test.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Median age was 66 years (47-80) and both groups were homogeneous with regard to: PSA, prostate volume, core’s number and educational level without significant differences. 74 patients (74%) had their first biopsy and 26 (26%) had their second one. The average number of core biopsy was 10,9±2, and VAS mean score for group A was 3,6±1,8 versus 3,2±2 Group B without significant differences (p>0,05). We found significant differences (p<0,05) between transducer introduction (3,9±1,9 group A/B group 4,3±2,2) and core biopsy (3,6±1,8 group A/B group 3,2±2,2). There were no differences between the data obtained with emotional impact test, age and educational level comparing to pain caused by prostate biopsy. Regard to the number of cores obtained there were no differences (p>0,05). Complications appeared in 12 patients (12%), 5 in the group of meperidine compared with 7 in the lidocaine without differences between them.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Periprostatic plexus blocked with lidocaine does not offer advantages respect to meperidine, despite the fact that this is a safe method that does not increase the number of complications. Placing transrectal transducer causes more pain than biopsy cores.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 0 | 2 | 2 |
| 2024 Octubre | 0 | 7 | 7 |
| 2024 Septiembre | 0 | 8 | 8 |
| 2024 Agosto | 0 | 4 | 4 |
| 2024 Julio | 0 | 6 | 6 |
| 2024 Junio | 0 | 13 | 13 |
| 2024 Mayo | 0 | 6 | 6 |
| 2024 Abril | 0 | 25 | 25 |
| 2024 Marzo | 0 | 27 | 27 |
| 2024 Febrero | 0 | 19 | 19 |
| 2024 Enero | 0 | 10 | 10 |
| 2023 Diciembre | 0 | 25 | 25 |
| 2023 Noviembre | 0 | 28 | 28 |
| 2023 Octubre | 0 | 33 | 33 |
| 2023 Septiembre | 0 | 17 | 17 |
| 2023 Agosto | 0 | 26 | 26 |
| 2023 Julio | 0 | 39 | 39 |
| 2023 Junio | 0 | 18 | 18 |
| 2023 Mayo | 0 | 8 | 8 |
| 2023 Marzo | 1 | 3 | 4 |
| 2023 Febrero | 0 | 9 | 9 |
| 2023 Enero | 0 | 6 | 6 |
| 2022 Diciembre | 0 | 3 | 3 |
| 2022 Noviembre | 0 | 7 | 7 |
| 2022 Octubre | 0 | 3 | 3 |
| 2022 Septiembre | 0 | 5 | 5 |
| 2022 Agosto | 0 | 12 | 12 |
| 2022 Julio | 0 | 1 | 1 |
| 2022 Junio | 0 | 3 | 3 |
| 2022 Mayo | 0 | 4 | 4 |
| 2022 Abril | 0 | 7 | 7 |
| 2022 Marzo | 0 | 8 | 8 |
| 2021 Diciembre | 0 | 3 | 3 |
| 2021 Noviembre | 0 | 4 | 4 |
| 2021 Octubre | 0 | 5 | 5 |
| 2021 Septiembre | 0 | 1 | 1 |
| 2021 Agosto | 0 | 2 | 2 |
| 2021 Julio | 0 | 1 | 1 |
| 2021 Junio | 0 | 2 | 2 |
| 2021 Abril | 0 | 2 | 2 |
| 2021 Marzo | 0 | 7 | 7 |
| 2021 Febrero | 0 | 5 | 5 |
| 2020 Diciembre | 0 | 3 | 3 |
| 2020 Noviembre | 0 | 6 | 6 |
| 2020 Octubre | 0 | 2 | 2 |
| 2020 Septiembre | 0 | 5 | 5 |
| 2020 Agosto | 0 | 6 | 6 |
| 2020 Julio | 0 | 1 | 1 |
| 2020 Junio | 0 | 2 | 2 |
| 2020 Mayo | 0 | 7 | 7 |
| 2020 Marzo | 0 | 3 | 3 |
| 2020 Febrero | 0 | 3 | 3 |
| 2020 Enero | 0 | 14 | 14 |
| 2019 Diciembre | 0 | 13 | 13 |
| 2019 Noviembre | 0 | 6 | 6 |
| 2019 Octubre | 0 | 4 | 4 |
| 2019 Septiembre | 0 | 7 | 7 |
| 2019 Agosto | 0 | 8 | 8 |
| 2019 Julio | 0 | 21 | 21 |
| 2019 Junio | 0 | 24 | 24 |
| 2019 Mayo | 0 | 55 | 55 |
| 2019 Abril | 0 | 20 | 20 |
| 2019 Marzo | 0 | 3 | 3 |
| 2019 Febrero | 0 | 9 | 9 |
| 2019 Enero | 0 | 4 | 4 |
| 2018 Diciembre | 0 | 7 | 7 |
| 2018 Noviembre | 0 | 8 | 8 |
| 2018 Octubre | 0 | 31 | 31 |
| 2018 Septiembre | 0 | 1 | 1 |
| 2018 Julio | 1 | 2 | 3 |
| 2018 Mayo | 0 | 2 | 2 |
| 2018 Febrero | 0 | 2 | 2 |
| 2018 Enero | 0 | 4 | 4 |
| 2017 Diciembre | 0 | 2 | 2 |
| 2017 Noviembre | 1 | 7 | 8 |
| 2017 Octubre | 4 | 4 | 8 |
| 2017 Septiembre | 1 | 5 | 6 |
| 2017 Agosto | 2 | 1 | 3 |
| 2017 Julio | 3 | 8 | 11 |
| 2017 Junio | 9 | 16 | 25 |
| 2017 Mayo | 13 | 5 | 18 |
| 2017 Abril | 16 | 9 | 25 |
| 2017 Marzo | 13 | 58 | 71 |
| 2017 Febrero | 11 | 10 | 21 |
| 2017 Enero | 12 | 4 | 16 |
| 2016 Diciembre | 26 | 19 | 45 |
| 2016 Noviembre | 42 | 17 | 59 |
| 2016 Octubre | 30 | 26 | 56 |
| 2016 Septiembre | 19 | 5 | 24 |
| 2016 Agosto | 12 | 2 | 14 |
| 2016 Julio | 17 | 12 | 29 |
| 2016 Junio | 21 | 26 | 47 |
| 2016 Mayo | 24 | 27 | 51 |
| 2016 Abril | 16 | 27 | 43 |
| 2016 Marzo | 18 | 30 | 48 |
| 2016 Febrero | 6 | 28 | 34 |
| 2016 Enero | 16 | 30 | 46 |
| 2015 Diciembre | 13 | 20 | 33 |
| 2015 Noviembre | 10 | 13 | 23 |
| 2015 Octubre | 17 | 15 | 32 |
| 2015 Septiembre | 14 | 13 | 27 |
| 2015 Agosto | 6 | 2 | 8 |
| 2015 Julio | 9 | 11 | 20 |
| 2015 Junio | 3 | 3 | 6 |
| 2015 Mayo | 2 | 0 | 2 |
| 2015 Abril | 10 | 15 | 25 |
| 2015 Marzo | 4 | 2 | 6 |
| 2015 Febrero | 1 | 1 | 2 |
| 2015 Enero | 6 | 5 | 11 |
| 2014 Diciembre | 6 | 7 | 13 |
| 2014 Noviembre | 5 | 1 | 6 |
| 2014 Octubre | 9 | 5 | 14 |
| 2014 Septiembre | 12 | 1 | 13 |
| 2014 Agosto | 8 | 1 | 9 |
| 2014 Julio | 8 | 0 | 8 |
| 2014 Junio | 5 | 5 | 10 |
| 2014 Mayo | 3 | 0 | 3 |
| 2014 Abril | 2 | 4 | 6 |
| 2014 Marzo | 4 | 2 | 6 |
| 2014 Febrero | 2 | 2 | 4 |
| 2014 Enero | 2 | 3 | 5 |
| 2013 Diciembre | 7 | 2 | 9 |
| 2013 Noviembre | 5 | 7 | 12 |
| 2013 Octubre | 3 | 7 | 10 |
| 2013 Septiembre | 5 | 7 | 12 |
| 2013 Agosto | 2 | 7 | 9 |
| 2013 Julio | 0 | 1 | 1 |
| 2009 Enero | 269 | 0 | 269 |
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