Dorsal penile nerve block alleviates pain in men undergoing rigid cystoscopy: A single-center, randomized, double-blind, and placebo-controlled trial.
Dorsal penile nerve block alleviates pain in men undergoing rigid cystoscopy: A single-center, randomized, double-blind, and placebo-controlled trial.
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作者：
Qiu Y;Liu X;Wei W;Du G
目的：比较阴茎背神经阻滞（DPNB）与丁卡因凝胶用于硬性膀胱镜检查镇痛的有效性和安全性。本研究是一项前瞻性、随机、双盲、安慰剂对照和单中心试验。接受诊断性硬性膀胱镜检查的男性被随机分为三组（每组n = 86）：（1）丁卡因凝胶组（DPNB与生理盐水），（2）DPNB组（DPNB与罗哌卡因+普通润滑剂），（3）联合组（DPNB与罗哌卡因+丁卡因凝胶）。主要结局是膀胱镜检查外括约肌时疼痛的视觉模拟评分（VAS）。DPNB组和联合用药组检查外括约肌时的VAS（中位数[四分位数]）显著低于丁卡因凝胶组（4 [3-6]和4 [3-5] vs 6 [5-7]，P < .0001），VAS中位数降低33%。与丁卡因凝胶组相比，DPNB组和联合组的疼痛程度明显减轻，HR和MAP更稳定，DPNB过程中未观察到阴茎血肿、勃起、局部麻醉剂中毒和膀胱镜检查不完整等不良事件。我们的研究表明，在接受诊断性硬性膀胱镜检查的男性中，DPNB联合或不联合丁卡因凝胶滴注提供的镇痛效果优于单独使用丁卡因凝胶提供的镇痛效果上级。ClinicalTrials.gov注册号：NCT 02502487。
To assess the effectiveness and safety of dorsal penile nerve block (DPNB) compared with tetracaine gel in analgesia for men undergoing rigid cystoscopy. This study was conducted as a prospective, randomized, double‐blind, placebo‐controlled, and single‐center trial. Men undergoing diagnostic rigid cystoscopy were randomly allocated into one of three groups (n = 86 each): (1) tetracaine gel group (DPNB with saline), (2) DPNB group (DPNB with ropivacaine + plain lubricant), and (3) combination group (DPNB with ropivacaine + tetracaine gel). The primary outcome was visual analog scale (VAS) for pain at cystoscopic inspection of the external sphincter. VAS (median [interquartile]) at inspection of the external sphincter was significantly lower in both DPNB and combination groups than that in tetracaine gel group (4 [3–6] and 4 [3–5] vs 6 [5–7], P < .0001), with a 33% reduction of median VAS. Overall pain level during procedure was significantly alleviated in the DPNB and combination groups with more stabilized HR and MAP when compared with tetracaine gel group. No adverse events were observed during DPNB including penile hematoma, erection, local anesthetic toxicosis or incompletion of cystoscopy. Our study suggests analgesia provided by DPNB with or without tetracaine gel instilled is superior to that provided by tetracaine gel alone in men undergoing diagnostic rigid cystoscopy. ClinicalTrials.gov registration number: NCT02502487.
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