Meperidine relieves pain during transrectal ultrasound-guided prostate biopsy

Objective: To compare the efficacy and safety of intramuscular meperidine injection with periprostatic nerve block (PNB) during transrectal ultrasound-guided prostate biopsy. Methods: This study was carried out from July 2010 to June 2012 at the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China. This controlled, double-blinded, randomized study included 186 patients. These patients were randomly assigned to 3 treatment groups: PNB by injection 10 minutes prior to the prostate biopsy; intramuscular meperidine injection administered 30 minutes before the biopsy, and a control group (n = 62, each). At the time of ultrasound probe insertion, during biopsy, and 30 minutes after biopsy, patients graded their level of pain on a 10-point visual analog scale (VAS). Results: There was no statistical difference in clinical features of the 3 groups. The patients administered meperidine had the minimum mean VAS score during probe insertion. During the prostate biopsy, there was no significant difference in VAS scores between patients in the PNB and meperidine groups, and both were significantly lower than that of the control group. The VAS scores recorded 30 minutes after biopsy were similar among the 3 groups. Conclusion: Intramuscular meperidine injection is a safe and effective analgesic for use during transrectal ultrasound-guided prostate biopsy, and provides better analgesia than PNB during the probe insertion.