Nitrous oxide decreases anxiety during transrectal prostate biopsy

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“I think if you were to ask what surprised me, I didn't expect it to have more of an effect on pain than anxiety,” says Heidi J. Rayala, MD, PhD.

In this video, Heidi J. Rayala, MD, PhD, shares the notable findings from the recent Journal of Urology study “Practical Use of Self-Adjusted Nitrous Oxide (SANO) During Transrectal Prostate Biopsy: A Double-Blind Randomized-Control Trial.” Rayala is an assistant professor of surgery at Harvard Medical School in Boston, Massachusetts.

Transcription:

What were some of the notable findings? Were any of them surprising to you and your coauthors?

When we were setting up the study, we, I think, anticipated that it would have a larger effect on anxiety than pain. So we kind of set the study up to look mainly at anxiety. Another question that we asked was, do these patients maintain their positioning? It's laughing gas. Are they moving around? Does it make the procedure harder for the operating urologist? So we also had a survey for the urologist. What we found was that the administration of nitrous oxide during a prostate biopsy decreases the pain that a patient perceives. But it did also decrease the anxiety, but not to a significant amount. It seemed to have more of an impact on pain. It did not add any increased time to the procedure itself. And the operating urologists perceived that the patient tolerated the procedure better. They were blinded; both the patient and the urologist were blinded, and they maintained the position similarly to those who were just getting the oxygen placebo. So I think if you were to ask what surprised me, I didn't expect it to have more of an effect on pain than anxiety. And I was actually pleasantly surprised to see in this study, and then in a follow-up study that we've done that patients actually seem to maintain their positions almost better because they're more relaxed.

This transcription was edited for clarity.

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