Introduction

1. A randomised controlled trial comparing use of periprostatic lignocaine nerve block alone and in combination with diclofenac suppository for patients undergoing transrectal ultrasound(TRUS) guided biopsy of prostate No. 175 Ooi WL1, Hawks C2,3, Hayne D1,2,3 1School of Surgery, University of Western Australia, 2Department of Urology, Fremantle Hospital, Western Australia, 3West Australian Urologic Research Organisation Posters Proudly Supported by: Introduction Transrectal ultrasound(TRUS)-guided prostate biopsy is the gold standard for diagnosing prostate cancer and can be safely performed under local anaesthetic (LA). Though generally well tolerated, patients may still report pain during LA prostate biopsy. Our study compared combination diclofenac suppository and lignocaine peri-prostatic nerve block(PPNB) vs lignocaine PPNB alone for TRUS-guided prostate biopsy. Pain experienced during and after the biopsy and the safety of both regimes were assessed in this placebo controlled single-blind randomised controlled trial. • Results • There was no difference between treatment (87%) and placebo (80%) groups with respect to whether they would prefer to repeat the biopsy under local anaesthetic (X2=0.794, p=0.373). • Aim • To compare pain experienced when combination diclofenac suppository and lignocaine peri-prostatic nerve block(PPNB) vs lignocaine PPNB alone were used in TRUS-guided prostate biopsy. • To assess safety of using both regimes in TRUS-guided prostate biopsy. Table 1: Demographic data and mean pain scores for the various periods in the two treatment groups. • Methods • Ninety six patients under-going TRUS-biopsy were randomised into 1) lignocaine periprostatic nerve block and placebo suppository or 2) lignocaine periprostatic nerve block and 100mg diclofenacsuppository. • Pain scores were recorded using the Numerical Rating Scale for pain(0-10) at the following periods: • 1. Introduction of probe • 2. During biopsy • 3. 1 hour post-biopsy • 4. Later that evening • 5. 1 day after biopsy • Patients were asked if a repeat TRUS-guided prostate biopsy was required, would they choose for it to be performed under local or general anaesthesia/sedation. Chart demonstrating pain score trend between treatment and placebo group. Acknowledgements Many thanks to the Kaleeya Hospital Endoscopy Unit staff members for its support. • Conclusions • A small difference in pain scores was demonstrated one hour post biopsy in the combination group though this is of doubtful clinical significance. • Using additional diclofenac suppository with PPNB is not recommended to decrease pain or improve tolerability of TRUS-guided prostate biopsy. • PPNB TRUS biopsy is extremely well tolerated. Over 80% of patients would elect for subsequent LA biopsy if required. References Ragavan N, Philip J, Balasubramanian SP, Desouza J, Marr C, Javle P. A randomized, controlled trial comparing lidocaineperiprostatic nerve block, diclofenac suppository and both for transrectal ultrasound guided biopsy of prostate. J Urol. 2005 Aug;174(2):510-3.