Journal of Research in Medical Sciences1735-1995232201802241075810758EN20180224<span class="fontstyle0">Background: </span><span class="fontstyle2">We aim to compare the degree of pain control and  complications in three types of anesthesia using periprostatic  nerve block (PPNB) plus intrarectal local anesthesia (IRLA), low?dose spinal anesthesia, and intravenous (IV) sedation in patients undergoing transrectal ultrasound (TRUS)?guided prostate biopsy. </span><span class="fontstyle0">Materials and Methods: </span><span class="fontstyle2">In this clinical trial study, 106 patients were participated from December 2015 to December 2016 at Alzahra Hospital, Isfahan, Iran. Patients were randomly allocated into three groups to receive PPNB plus IRLA (</span><span class="fontstyle3">n </span><span class="fontstyle2">= 36), low?dose spinal anesthesia (</span><span class="fontstyle3">n </span><span class="fontstyle2">= 35) and IV sedation (</span><span class="fontstyle3">n </span><span class="fontstyle2">= 35) before TRUS?guided<br />prostate biopsy. Pain scores were recorded using a 10 point visual analog scale right after the biopsy was done. Early and late complications were assessed using a questionnaire after the procedure and in follow?up of patients. </span><span class="fontstyle0">Results: </span><span class="fontstyle2">Overall, the pain score in the low?dose spinal anesthesia group was signifcantly lower than PPNB plus IRLA and IV sedation groups (</span><span class="fontstyle3">P </span><span class="fontstyle2">&lt; 0.001). Te di?erences in pain scores between PPNB plus IRLA group and IV sedation group were not signifcant (</span><span class="fontstyle3">P </span><span class="fontstyle2">= 0.30). Urinary retraction<br />and fever were signifcantly more frequent in low?dose spinal anesthesia and IV sedation, retrospectively (</span><span class="fontstyle3">P </span><span class="fontstyle2">= 0.04, </span><span class="fontstyle3">P </span><span class="fontstyle2">= 0.03). No signifcant di?erence in late complications was found among the groups. </span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">Tis study demonstrates that low?dose spinal anesthesia is superior to PPNB plus IRLA and IV sedation in terms of pain controlling and was associated with higher tolerance of the examination and patient comfort. </span> <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://jrms.mui.ac.ir/index.php/jrms/article/view/10758http://jrms.mui.ac.ir/index.php/jrms/article/download/10758/5599