Intravenous paracetamol for relief of pain during transrectal-ultrasound-guided biopsy of the prostate: A prospective, randomized, double-blind, placebo-controlled study

• Published in: The Kaohsiung journal of medical sciences 2015-11, Vol.31 (11), p.572-579
• Main Authors: Kilic, Ozcan, Akand, Murat, Kulaksizoglu, Haluk, Haliloglu, Ahmet H, Tanidik, Seher, Piskin, Mehmet M, Yurdakul, Talat
• Format: Article
• Language: English
• Subjects: Acetaminophen; Acetaminophen - administration & dosage; Acetaminophen - therapeutic use; Administration, Intravenous; Aged; Aged, 80 and over; Analgesia; Biopsy; Care and treatment; Demography; Double-Blind Method; Humans; Internal Medicine; Male; Medical research; Medicine, Experimental; Middle Aged; Pain; Pain - drug therapy; Pain Measurement; Paracetamol; Placebos; Prospective Studies; Prostate; Prostate - pathology; Prostate cancer; Prostate-specific antigen; Rectum - pathology; Transrectal ultrasound; Ultrasonics
• ISSN: 1607-551X; 2410-8650
• DOI: 10.1016/j.kjms.2015.09.003

Abstract Transrectal-ultrasound-guided prostate biopsy (TRUS-PBx) is the standard procedure for diagnosing prostate cancer. The procedure does cause some pain and discomfort; therefore, an adequate analgesia is necessary to ensure patient comfort, which can also facilitate good-quality results. This prospective, randomized, double-blinded, placebo-controlled study aimed to determine if intravenous (IV) paracetamol can reduce the severity of pain associated with TRUS-PBx. The study included 104 patients, scheduled to undergo TRUS-PBx with a suspicion of prostate cancer, that were prospectively randomized to receive either IV paracetamol (paracetamol group) or placebo (placebo group) 30 minutes prior to TRUS-PBx. All patients had 12 standardized biopsy samples taken. Pain was measured using a 10-point visual analog pain scale during probe insertion, during the biopsy procedure, and 1 hour postbiopsy. All biopsies were performed by the same urologist, whereas a different urologist administered the visual analog pain scale. There were not any significant differences in age, prostate-specific antigen level, or prostate volume between the two groups. The pain scores were significantly lower during probe insertion, biopsy procedure, and 1 hour postbiopsy in the paracetamol group than in the placebo group. In conclusion, the IV administration of paracetamol significantly reduced the severity of pain associated with TRUS-PBx.