关键词: 前列腺, 穿刺, 疼痛, 麻醉, 氟比洛芬酯

Abstract: Objective： To examine the effects of perioperative intravenous administration of flurbiprofen axetil (FA) on pain associated with transrectal ultrasound-guided prostate biopsy. Methods： This was a randomized，controlled study. Eighty-one patients who underwent 12 core prostate biopsy were included in  the study. The patients were randomly assigned to one of three groups (n=27 in each) by type of procedure during prostate biopsy. Group intrarectal local anesthesia (IRLA) received intrarectal 5% (0.05 g/L) lidocaine gel 60 mg, 5 minutes before the procedure alone； Group FA received intravenous flurbiprofen axetil (1 mg/kg) 1 hour before the procedure；Group IRLA+FA received intrarectal 5% lidocaine gel 60 mg,  5 minutes before the procedure and intravenous flurbiprofen axetil (1 mg/kg) 1 hour before the procedure. The patients were asked to score the pain by using visual analogue scale (VAS) in 4 situations，including when the probe was inserted (VASⅠ)，during anesthesia (VASⅡ)，during biopsy (VASⅢ) and 20 minutes after biopsy (VASⅣ). The findings were evaluated with analysis of variance，and the Tukey post hoc test was followed with an overall 2-tailed significance level at α =0.05. P1, P value between Group IRLA and Group FA；P2, P value between Group FA and Group IRLA +FA，P3, P value between Group IRLA and Group IRLA +FA. The bonferroni method was used to adjust the test level, α=0.017，a P value of less than 0.017 was accepted as the threshold for statistical significance. Results： No major complications，including sepsis and severe rectal bleeding，were noted in any patient. There were no differences in general condition of the patients before procedure among the 3 groups. There were statistically significant differences in VAS scores among the 3 groups in VASⅡ (5.7±2.2， 3.0±1.5，3.3±1.9，respectively，P=0.012) and VASⅢ (6.7±2.3，3.0±2.1，2.9±1.6，respectively，P=0.001). There were no differences in the pain scores among the 3 groups during probe insertion (VASⅠ, 3.2±1.0，4.1±2.1，4.2±1.7， respectively，P=5.752) and 20 minutes after biopsy (VASⅣ, 1.4±2.1，1.0±0.9，1.1±0.7，respectively，P=3.772). Betweencolumn differences among the 3 groups were VASⅡ (P1=0.007，P2=5.655，P3=0.001，respectively) and VASⅢ(P1=0.008，P2=7.517，P3=0.001，respectively)，the differences between Group IRLA and Group FA，Group IRLA and Group IRLA +FA in VASⅡ and VASⅢ were statistically significant. Conclusion：The intravenous flurbiprofen axetil was found to be more effective than intrarectal lidocaine gel alone.

Key words: Prostate, Biopsy, Pain, Anesthesia, Flurbiprofen axetil