title: Diclofenac Suppository as a Preemptive Analgesia in Ultrasound-guided Biopsy of Prostate: Randomized Controlled Trial.
abstract: OBJECTIVE
  To compare preprocedure Diclofenac suppository and Xylocaine gel with Xylocaine gel only in patients undergoing transrectal ultrasound (TRUS)-guided biopsy of prostate for pain.
  
  
  METHODS
  It is a randomized controlled trial conducted on patients undergoing TRUS-guided biopsy for clinical or biochemical suspicion of prostate cancer following a written informed consent and Ethics Review Committee approval. Patients were randomized into 2 groups. Group A included those patients who received Diclofenac suppository 2 hours before in combination with 10 mL of 2% Xylocaine gel 5 minutes before biopsy. Group B received Xylocaine gel only. A visual analog scale was used to measure the pain scores at the time of TRUS probe insertion, just after taking biopsy cores and 2 hours after biopsy.
  
  
  RESULTS
  A total of 100 patients were recruited in the study with 50 patients each in group A and B. Mean age of group A was 69.1 ± 10 years and 67.3 ± 8.1 years for group B. The mean pain score for group A and B at the time of probe insertion was 0.08 ± 0.27 and 0.34 ± 0.63 (P = .032), immediately after taking biopsy cores was 1.46 ± 1.15 and 4.68 ± 0.77 (P = .000), and 2 hours after biopsy was 0.14 ± 0.45 vs 2.40 ± 0.81 (P = .000), respectively.
  
  
  CONCLUSIONS
  The mean pain score at the time of TRUS probe insertion, immediately after taking biopsy cores, and 2 hours after biopsy is statistically significantly higher in group B.
authors.affiliation: Department of Surgery, Aga Khan University, Karachi, Pakistan.
authors.forename: Naveed
authors.initials: N
authors.lastname: Haroon
authors.affiliation: Department of Surgery, Aga Khan University, Karachi, Pakistan. Electronic address: hammad.ather@aku.edu.
authors.forename: M Hammad
authors.initials: MH
authors.lastname: Ather
authors.affiliation: Department of Surgery, Aga Khan University, Karachi, Pakistan.
authors.forename: Salma
authors.initials: S
authors.lastname: Khan
authors.affiliation: Department of Surgery, Aga Khan University, Karachi, Pakistan.
authors.forename: Pirkash
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Department of Surgery, Aga Khan University, Karachi, Pakistan.
authors.forename: Basit
authors.initials: B
authors.lastname: Salam
mesh_terms: D000285:Administration, Rectal; D000368:Aged; D000698:Analgesia / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D004008:Diclofenac / Q000008:administration & dosage*; D004338:Drug Combinations; D019160:Endosonography; D005500:Follow-Up Studies; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D059408:Pain Management / Q000379:methods*; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D012007:Rectum; D012187:Retroperitoneal Space; D013488:Suppositories
chemical_list: D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D013488:Suppositories; D004008:Diclofenac; D008012:Lidocaine