Prostat Biyopsisi Yapılan Hastalarda Beden Kitle İndeksinin Ağrı Skorları Üzerine Olan Etkisi
GİRİŞ ve AMAÇ: Bu çalışmada TRUS-PBx'deki ağrı skorları ile hastaların beden kitle indeksleri (BKİ) arasındaki ilişki araştırılmıştır. YÖNTEM ve GEREÇLER: Ekim 2014-Nisan 2015 arasında anormal parmakla rektal muayene bulgusu ve/veya yüksek prostat spesifik antijen (PSA) düzeyi (>=2,5 ng/ml) nedeniyle TRUS-PBx yapılan toplam 198 hasta çalışmaya dâhil edildi. Biyopsi öncesinde tüm hastalara 10 ml %2 prilokainle transperineal periprostatik sinir blokajı uygulandı. Ağrı skorları 10'luk lineer vizüel analog skala (VAS) kullanılarak, ultrason probu rektuma yerleştirildikten hemen sonra (VAS-1) ve biyopsi esnasında iğne girişi sırasında (VAS-2) ağrı düzeyi değerlendirildi. BKİ'ye göre hastalar 2 gruba ayrıldılar: Grup-1 (n=156) BKİ=30 kg/m2 olan hastaları içermekteydi. BULGULAR: Hastaların ortalama yaşı 64±7.3 yıl ve ortalama PSA değeri 12.5±18.3 ng/dl idi. Prostat kanseri tespit oranı %22.7 idi. Grup-1'deki hastaların VAS-1 skoru grup- 2'dekilerden yüksek olmakla birlikte (1.8±2.1 vs 1.3±1.6), aradaki fark istatistiksel olarak anlamlı değildi (p=0.123). Diğer yandan, ortalama VAS-2 skorları grup-1'de 2.7±2.6, grup-2'de 1.9±1.7 idi ve aradaki fark istatistiksel olarak anlamlıydı (p=0.026). TARTIŞMA ve SONUÇ: BKİ düşük olan hastalar TRUS-PBx işleminde prostat örneklemesi sırasında daha fazla ağrı hissetmektedirler. Bu hastaların konforunu artırmak için alternatif anestezi teknikleri göz önünde bulundurulmalıdır.
The Effect of Body Mass Index on Pain Scores in Patients Who Underwent Prostate Biopsy
INTRODUCTION: In this study we assessed the relationship between pain scores during transrectal ultrasound-guided prostate biopsy (TRUS-PBx) and body mass index (BMI) of the patients. MATERIAL and METHOD: Between October 2014-April 2015, 198 patients who underwent prostate biopsy with abnormal digital rectal examination findings and/or high PSA levels (>=2,5 ng/ml) were included in this study. Before the biopsy procedure, all patients underwent transperineal periprostatic block with 10 mL of 2% prilocaine. A 10-point linear visual analogue scale (VAS) was used to assess the pain arising from probe insertion (VAS-1) and prostate sampling (VAS-2). According to BMI, patients were divided into 2 groups: Group-1 (n=156) included BMI<30 kg/m2 and Group2 (n=42) included BMI >=30 kg/ m2. RESULTS: The mean age of the patients was 64±7.3 years, and the mean PSA value was 12.5±18.3 ng/dl. Prostate cancer detection rate was 22.7%. VAS-1 score was higher in group-1 than group-2 (1.8±2.1 vs 1.3±1.6), however, the difference was not statistically significant (p=0.123). The mean VAS-2 scores were 2.7±2.6 in group-1 and 1.9±1.7 in group-2 and the difference was statistically significant (p=0.026).DISCUSSION AND CONCLUSION: Patients with a low BMI feel more pain at the time of prostate sampling during TRUSPBx. In these patients alternative anesthesia techniques can be considered in order to increase the patients' comfort.
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