[en] lntroduction. Prostate cancer (PC) is the third most frequent tumor location in Spanish men. A prostate biopsy is the fundamental diagnostic method to obtain prognostic information and decide the most appropriate treatment. Despite being a minimally invasive procedure, it can produce sorne discomfort and pain, causing many patients to avoid future biopsies. No studies are evaluating local anesthesia in patients who undergo saturation prostate biopsies. Material and method. Alter approval by the ethics committee and the Spanish drug agency, a prospective and randomized study was carried out with 100 patients with at least two previous negative biopsies and candidates far saturation prostate biopsy. lt was randomized in -a 1: 1 ratio into the control group (intravenous sedation with midazolam, fentanyl, and ketamine) and the intervention group (1% periprostatic mepivacaine). Twenty-four cylinders were collected from ali patients. The mean DE was: age (66.2±5.9), BMI (27.84±4.2), total PSA (8.31±5.0), % free PSA (19.06±6, 3), and prostate vol u me (72.54±33.2). The primary variable is the visual analog scale (VAS). Results. Both groups are homogeneous in the main clinical variables (age, PSA, prostate volume, and BMI). The technique was effective in ali patients in the intervention group. The mean global pain was mild (0.825±1.36). Significan! differences were observed between both groups at the time of the biopsy (0.548±1.48 vs. 1.102±1.18, p <0.001), being more effective in the sedation group. However, there were not statistical differences at the time of hospital discharge (0.509±1.15 vs. 0.369±0, 9; p = 0.541). The complication rate was very low, less than 10%, with hemorrhagic events being the most frequent, but without clinical repercussions. Conclusions. The periprostatic infiltration technique of Mepivacaine 1% is effective and safe in controlling pain perceived in saturation prostate biopsy. This technique makes it possible to reduce preoperative studies and anesthetic consultations associated with intravenous sedation. Together, it will allow better management of financia! and healthcare resources and the availability of the operating room.

[gl] lntrodución. O cancro de próstata (CP) é a terceira localización tumoral máis frecuente nos homes españois. A biopsia de próstata é o método diagnóstico fundamental para obter información de prognóstico e decidir o tratamento máis axeitado. A pesar de ser un procedemento mínimamente invasivo, pode producir certa molestia e dar, facendo que moitos pacientes eviten futuras biopsias. Non hai estudos que avalíen a anestesia local en pacientes sometidos a biopsias de próstata saturadas. Material e método. Despois da aprobación do comité de ética e da axencia española de medicamentos, levouse a cabo un estudo prospectivo e aleatorizado con 100 pacientes con polo menos 2 biopsias negativas anteriores e candidatos a biopsia de próstata saturada. Foi aleatorizado nunha proporción de 1: 1 no grupo control (sedación intravenosa con midazolam, fentanilo e ketamina) e no grupo de intervención (1% de mepivacaína periprostática). Recolléronse 24 cilindros de todos os pacientes. A SD media foi: idade (66,2±5,9), IMC (27,84±4,2), PSA total (8,31±5,0), % de PSA libre (19,06±6, 3) e volume de próstata (72,54±33,2). A variable principal é a escala analóxica visual (VAS). Resultados. Ambos grupos son homoxéneos nas principais variables clínicas (idade, PSA, volume de próstata e IMC). A técnica foi eficaz en todos os pacientes do grupo de intervención. A dar global media foi leve (0,825 ± 1,36). Observáronse diferenzas significativas entre ambos grupos no momento da biopsia (0,548-1,48 vs 1,102-1,18, p <0,001), senda menos dolorosa a sedación intravenosa. No momento da alta hospitalaria, non se observou ningunha diferenza estatística (0,509±1,15 vs 0,369±0, 9; p = 0,541). A taxa de complicacións foi moi baixa, inferior ao 10%, senda os eventos hemorráxicos os máis frecuentes, pero sen repercusións clínicas. Conclusións. A técnica de infiltración peri prostática de Mepivacaína ao 1% é eficaz e segura para controlar a dar percibida na biopsia de próstata saturada. Esta técnica permite reducir os estudos preoperatorios e as consultas anestésicas asociadas á sedación intravenosa. En conxunto, permitirá unha mellar xestión dos recursos financeiros e sanitarios, así como a dispoñibilidade do quirófano.