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Control of pain during transrectal ultrasound-guided prostate biopsy: a prospective study comparing two methods
K K Bhomi1, H H Lim, D T Consigliere
1Department of Urology, National University Hospital, Singapore, Singapore.
Aim:
To evaluate the efficacy of intramuscular injection of 75 mg diclofenac sodium and periprostatic nerve block (PPNB) with 1% lignocaine in controlling pain during transrectal ultrasound (TRUS)-guided prostate biopsy.
Materials And Methods:
A total of 120 patients undergoing TRUS-guided prostate biopsies were prospectively enrolled in the study. First, 20 patients did not get any form of analgesia/anesthesia and served as control; next, 20 patients received an intramuscular injection of diclofenac sodium. PPNB with 1% lignocaine was performed in the remaining 80 patients. Pain was assessed using Wong-Baker Faces Pain-Rating Scale (0-10).
Results:
All three groups of patients were comparable at baseline in terms of age, prostate-specific antigen and final histological diagnosis. The mean pain scores (+/-SD) for control, diclofenac and PPNB groups were 5.10 +/- 3.14, 3.70 +/- 2.36 and 2.24 +/- 1.63, respectively. The difference was statistically significant between control and PPNB (p = 0.001), and diclofenac and PPNB (p = 0.002), but not between the control and diclofenac group (p = 0.120). In addition, the proportion of patients having mild or no pain (defined as pain score
Conclusion:
PPNB with 1% lignocaine significantly decreases pain associated with prostate biopsy when compared with control and intramuscular diclofenac.
