Tramadol Improves Patients’ Tolerance of Transrectal Ultrasound-Guided Prostate Biopsy

ObjectivesTo evaluate the analgesic advantage of tramadol in patients undergoing transrectal biopsy of the prostate in ambulatory settings compared with topical analgesia.MethodsA total of 77 patients scheduled for prostate biopsy were randomly assigned to receive 5% lidocaine ointment 5 mL per rectum 10 minutes before the procedure (group 1) or lidocaine ointment combined with tramadol drops 1 mg/kg per os 40 minutes before the procedure (group 2). Pain severity, main cardiorespiratory parameters, difficulty of the procedure, procedure-related side effects, and complications were analyzed.ResultsNo significant respiratory or hemodynamic disturbances were observed. The pain severity, as measured on a visual analog scale, was significantly lower in group 2 (P = 0.038), and the rate of overall satisfaction with the level of analgesia was significantly greater (P = 0.027). The urologist’s assessment of “very easy” was assigned to 77.1% of procedures in group 2 compared with 54.8% of procedures in group 1 (P = 0.04). The rate of side effects in both groups was similar at 9.5% versus 11.4% (P = 0.785).ConclusionsThe combination of lidocaine per rectum with tramadol per os is a simple and safe technique providing good analgesic effect and, therefore, can be recommended for transrectal ultrasound-guided prostate biopsy.