Buffered Lidocaine for Reducing Pain in Patients Undergoing Prostate Biopsy, BURN Trial

Clinicaltrials.gov ID: NCT06661902
db-list-check Status RECRUITING
b-loader Phase PHASE1, PHASE2
b-people Age ≥ 18 Years
b-bullseye-arrow Enrollments 300

Conditions

Prostate Cancer

Drugs

Buffered Lidocaine (1% Lidocaine + 8.4% Sodium Bicarbonate, in a 3:1 ratio), Lidocaine

Summary

This phase I/II trial examines if buffered lidocaine reduces the pain that patients may experience during prostate biopsy. Prostate biopsies are typically performed awake, in the office, with only local anesthetic. As a result, many patients note considerable pain during these procedures. Local anesthetics such as lidocaine are typically acidic, which is thought to cause pain and burning during infiltration (injection). As a result, buffered local anesthetic has become the standard of care (SOC) in multiple specialties using awake local anesthetic. However, it has not been explored during prostate biopsies. Adminstering buffered lidocaine may reduce pain in patients undergoing prostate biopsy.

Detailed Description

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM A: Patients receive SOC lidocaine via injection during SOC prostate biopsy on study.

ARM B: Patients receive buffered lidocaine via injection during SOC prostate biopsy on study.

After completion of study intervention, patients are followed up 1-2 days post-biopsy.

Locations

1 location Found with status Recruiting

Status

  • RECRUITING

Contact Person

Principal Investigator

  • Alexander Zhu, DO

Eligibility Criteria

Inclusion Criteria:

* Provision of signed and dated informed consent form
* 18 years old or older
* Patients with prostates
* Those with and without a prior diagnosis of prostate cancer
* Recommended to undergo a prostate biopsy in the urology clinic. Only patients that have been scheduled for a biopsy (for clinical purposes) will be enrolled. May include all of the following types of prostate biopsies:

* Transperineal or transrectal
* Systematic or targeted/fusion biopsy
* 12 core biopsy or > 12cores
* Biopsy naïve or prior biopsy

Exclusion Criteria:

* Anorectal pathology precluding placement of a transrectal ultrasound
* Diagnosis of chronic prostatitis, interstitial cystitis, pelvic pain syndrome
* Concomitant chronic pain condition
* Neurological condition affecting pain or sensorium (ex. spinal cord injury, stroke, multiple sclerosis, etc.)
* Prostate biopsy performed with any anesthesia other than local anesthetic (monitored anesthesia care, general anesthesia)
* Prostate biopsy completed in the operating room
* Patients who ultimately require additional local anesthetic beyond what is allotted in the study intervention
* Patients taking anxiolytics in the 6-hours prior to the biopsy
* Those with a known hypersensitivity, allergic reaction, or contraindication to using sodium bicarbonate. This includes patients who are receiving diuretics known to produce a hypochloremic alkalosis

Study Plan

Arm A (lidocaine)

ACTIVE_COMPARATOR

Patients receive SOC lidocaine via injection during SOC prostate biopsy on study.

  • DRUG:

    Lidocaine

    Description:

    Given via injection
  • PROCEDURE:

    Biopsy of Prostate

    Description:

    Undergo SOC prostate biopsy
  • OTHER:

    Questionnaire Administration

    Description:

    Ancillary studies

Arm B (buffered lidocaine)

EXPERIMENTAL

Patients receive buffered lidocaine via injection during SOC prostate biopsy on study. (1% Lidocaine + 8.4% Sodium Bicarbonate, in a 3:1 ratio)

  • DRUG:

    Buffered Lidocaine (1% Lidocaine + 8.4% Sodium Bicarbonate, in a 3:1 ratio)

    Description:

    Given via injection
  • PROCEDURE:

    Biopsy of Prostate

    Description:

    Undergo SOC prostate biopsy
  • OTHER:

    Questionnaire Administration

    Description:

    Ancillary studies

Outcome Measures

Primary Outcome Measures

Pain of Local Anesthetic Injection

Time Frame: Within 20 seconds of completing the injection of all local anesthetic

Secondary Outcome Measures

Pain of the Prostate Biopsy

Time Frame: Within 10 minutes of completing the prostate biopsy, and on post-operative day 1

Willingness to perform another prostate biopsy in the future, if medically necessary

Time Frame: Within 10 minutes of completing the prostate biopsy, and on post-operative day 1

Incidence of adverse events

Time Frame: Post-operative day 1

Timeline

  • Last Updated
    February 3, 2025
  • Start Date
    October 28, 2024
  • Today
    May 12, 2025
  • Completion Date ( Estimated )
    February 1, 2026

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