Efficacy of Voltaren Suppository in Adjunct with Peri- Prostatic Nerve Block with Lignocaine as Analgesia for Transrectal Ultrasound- Guided Biopsy of Prostate
H. Y. Khor *
Urology Unit of Hospital Raja Perempuan Zainab II, Malaysia.
M. Arif Khairuddin
Urology Unit of Hospital Raja Perempuan Zainab II, Malaysia.
N. Azam Nasuha
Urology Unit of Hospital Raja Perempuan Zainab II, Malaysia.
*Author to whom correspondence should be addressed.
Abstract
Objectives: To evaluate the efficacy of suppository voltaren as an adjunct analgesia during transrectal ultrasound (TRUS) biopsy using numerical pain score.
Methods: A total of 48 patients who were subjected to TRUS biopsy of prostate were enrolled in this study. The patients were randomly divided into 2 groups equally. In group 1, the patients received the standard peri- prostatic nerve block (PPNB) consisting of 10ml of 1% lignocaine. In group 2, the patients received peri- prostatic nerve block consisting of 10ml 1% lignocaine and in addition of voltaren suppository 100mg which was administered 1 hour before the procedure. During procedure, the patients were assessed on their pain score using numerical pain score 0-10 during insertion of transrectal probe, administration of peri- prostatic nerve block, during biopsy and 1- hour post- biopsy.
Results: There was significant lower pain score in with regard to group 2 patients during probe insertion, PPNB administration and during biopsy. Pain score 1 hour post- procedure was not significant as the pain score in both groups were generally low.
Conclusions: We believe that by adding voltaren suppository 100mg 1 hour before the procedure would be an advantage for patients as this study had shown significant lower pain score throughout the procedure with no increase in morbidity.
Keywords: TRUS, PPNB, voltaren suppository
How to Cite
References
Irer B, Gulcu A, Aslan G, Goktay Y, Celebi I. Diclofenac suppository administration in conjunction with lidocaine gel during transrectal ultrasound-guided prostate biopsy: prospective, randomized, placebo- controlled study. Urology. Oct 2005;66(4): 799–802.
Haq A, Patel HRH, Habib MR, Donaldson PJ, Parry JRW. Diclofenac suppository analgesia for transrectal ultrasound guided biopsies of the prostate: a double-blind, randomized controlled trial. J Urol. Apr 2004;171(4):1489–1491.
Analgesia for Prostate Biopsy: Efficacy of Diclofenac Patch versus Diclofenac Suppository as Compared to Placebo during Prostate Biopsy | Semantic Scholar [Internet]. Cited; Sep 7 2021.
Treede R-D. The International Association for the Study of Pain definition of pain: as valid in 2018 as in 1979, but in need of regularly updated footnotes. Pain Reports [Internet]. 2018 Mar cited. Feb 25 2022;3(2).
Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5902252/.
Nazir B. Pain during Transrectal Ultrasound-Guided Prostate Biopsy and the Role of Periprostatic Nerve Block: What Radiologists Should Know. Korean Journal of Radiology. Oct 2014; 15(5):543.
Voltarol 12.5 mg Suppositories - Summary of Product Characteristics (SmPC) - (emc) [Internet]. Cited; Mar 16 2022. Available:https://www.medicines.org.uk/emc/product/1044/smpc#gref
Available:https://www.npra.gov.my/images/reg-and-noti/PI/scheduled-poison/Diclofenac_Sodium_Suppository.pdf
Singh JC, Kekre NS. Diclofenac suppository administration in conjunction with lidocaine gel during transrectal ultrasound-guided prostate biopsy. Indian Journal of Urology. Jul 1 2005;21(2):799-802.
Ragavan N, Philip J, Balasubramanian SP, DeSOUZA J, Marr C, Javle P. A randomized, controlled trial comparing lidocaine periprostatic nerve block, diclofenac suppository and both for transrectal ultrasound guided biopsy of prostate. Journal of Urology. Aug 2005; 174(2):510–513.
Haroon N. Diclofenac Suppository as a Preemptive Analgesia in Ultrasound Guided Biopsy of Prostate: Randomized Controlled Trial [Internet].
clinicaltrials.gov; Sep 2013. [cited 2021 May 5]. Report No.: NCT01939743.
Aus G, Damber J-E, Hugosson J. Prostate biopsy and anaesthesia: An overview. Scandinavian Journal of Urology and Nephrology. Apr 1 2005; 39(2):124–129.