A randomised controlled trial comparing use of lignocaine periprostatic nerve block alone and combined with diclofenac suppository for patients undergoing transrectal ultrasound (TRUS)-guided prostate biopsy

被引:10
作者
Ooi, Wei Ling [1 ,2 ]
Hawks, Cynthia [2 ,3 ]
Tan, Andrew H. H. [3 ]
Hayne, Dickon [1 ,2 ,3 ]
机构
[1] Univ Western Australia, Sch Surg, Perth, WA 6160, Australia
[2] Fremantle Hosp, Dept Urol, Perth, WA, Australia
[3] West Australian Urol Res Org, Perth, WA, Australia
关键词
prostate; biopsy; transrectal; diclofenac; lignocaine; LOCAL-ANESTHESIA TECHNIQUES; GUIDED BIOPSY; PAIN; MANAGEMENT; PHARMACOKINETICS; LIDOCAINE; EFFICACY; PARACETAMOL; MORBIDITY; TOLERANCE;
D O I
10.1111/bju.12610
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
ObjectiveTo examine whether or not the combination of diclofenac suppository with peri-prostatic nerve block (PPNB) was effective in reducing the degree of pain experienced during transrectal ultrasound (TRUS)-guided prostate biopsy in a randomised single-blind placebo-controlled trial. Patients and MethodsIn all, 96 patients having a planned TRUS-guided prostate biopsy were randomised into one of the following arms on a 1:1 basis: 10mL 1% lignocaine PPNB and placebo suppository (control) or 10mL 1% lignocaine PPNB and 100mg diclofenac suppository (treatment). Pain scores were recorded using the Numerical Rating Scale for pain (0-10) at the following time-points: (i) introduction of probe, (ii) during biopsy, (iii) 1h after biopsy, (iv) later that evening (approximate to 6h after biopsy) and (v) 1 day after biopsy. Patients were asked about their preferred method for pain control if a repeat TRUS-guided prostate biopsy was required: local anaesthetic (LA) again or intravenous sedation. ResultsThere were no significant differences in age (P = 0.653) or PSA level (P = 0.584) between either study arm. The differences in pain scores between the control and treatment groups were not significant at Time 1 (probe insertion; P = 0.299), Time 2 (biopsy; P = 0.983), Time 4 (evening after; P = 0.231) and Time 5 (1 day after biopsy; P = 0.384). At Time 3 (1h after biopsy), the control pain scale scores were statistically significantly higher than the treatment pain scale scores (P = 0.044). There was no difference between treatment (87%) and control (80%) groups as to whether they would prefer to repeat the biopsy under LA (P = 0.373). ConclusionThe use of a diclofenac suppository with PPNB did not show any clinically meaningful effect in decreasing pain or improving tolerability of TRUS-guided prostate biopsy and is not recommended. PPNB TRUS-guided biopsy is extremely well tolerated, with >80% of patients electing for subsequent LA biopsy if required.
引用
收藏
页码:45 / 49
页数:5
相关论文
共 31 条
  • [1] 'Multimodal' approach to management of prostate biopsy pain and effects on sexual function: efficacy of levobupivacaine adjuvant to diclofenac sodium - a prospective randomized trial
    Aktoz, T.
    Kaplan, M.
    Turan, U.
    Memis, D.
    Atakan, I. H.
    Inci, O.
    [J]. ANDROLOGIA, 2010, 42 (01) : 35 - 40
  • [2] Control of pain during transrectal ultrasound-guided prostate biopsy: A prospective study comparing two methods
    Bhomi, K. K.
    Lim, H. H.
    Consigliere, D. T.
    Tiong, H. Y.
    [J]. UROLOGIA INTERNATIONALIS, 2007, 79 (04) : 332 - 335
  • [3] SIDE-EFFECTS AND PATIENT ACCEPTABILITY OF TRANSRECTAL BIOPSY OF THE PROSTATE
    CLEMENTS, R
    AIDEYAN, OU
    GRIFFITHS, GJ
    PEELING, WB
    [J]. CLINICAL RADIOLOGY, 1993, 47 (02) : 125 - 126
  • [4] MULTIPLE TRANSRECTAL ULTRASOUND-GUIDED PROSTATIC BIOPSIES - TRUE MORBIDITY AND PATIENT ACCEPTANCE
    COLLINS, GN
    LLOYD, SN
    HEHIR, M
    MCKELVIE, GB
    [J]. BRITISH JOURNAL OF UROLOGY, 1993, 71 (04): : 460 - 463
  • [5] De Maria M, 2006, J ENDOUROL, V20, P525
  • [6] Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale
    Farrar, JT
    Young, JP
    LaMoreaux, L
    Werth, JL
    Poole, RM
    [J]. PAIN, 2001, 94 (02) : 149 - 158
  • [7] Bleeding after transrectal ultrasonography-guided prostate biopsy: a study of 7-day morbidity after a six-, eight- and 12-core biopsy protocol
    Ghani, KR
    Dundas, D
    Patel, U
    [J]. BJU INTERNATIONAL, 2004, 94 (07) : 1014 - 1020
  • [8] Diclofenac suppository analgesia for transrectal ultrasound guided biopsies of the prostate: A double-blind, randomized controlled trial
    Haq, A
    Patel, HRH
    Habib, MR
    Donaldson, PJ
    Parry, JRW
    [J]. JOURNAL OF UROLOGY, 2004, 171 (04) : 1489 - 1491
  • [9] TBANSRECTAL ULTRASOUND-GUIDED PROSTATE BIOPSY, PERIPROSTATIC LOCAL ANESTHESIA AND PAIN TOLERANCE
    Hiros, Mustafa
    Selimovic, Mirsad
    Spahovic, Hajrudin
    Sadovic, Sabina
    Spuzic-Celic, Ediba
    [J]. BOSNIAN JOURNAL OF BASIC MEDICAL SCIENCES, 2010, 10 (01) : 68 - 72
  • [10] Howat A, 2006, Rural Remote Health, V6, P563