Pain scores of patients undergoing finger-guided prostate biopsy using lignocaine and oral paracetamol at the University Teaching Hospital in Lusaka, Zambia – a cross-sectional study

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LT Matanhike


Purpose: To evaluate the pain scores of patients undergoing a finger-guided prostate biopsy using lignocaine intra-rectal gel and oral paracetamol at the University Teaching Hospital (UTH) in Lusaka, Zambia.

Materials and methods: This is a cross-sectional study comprised of 78 participants. Oral paracetamol (1 000 mg) was taken 30–60 minutes before the biopsy and 10 ml intra-rectal lignocaine gel was given three minutes before the biopsy. The Faces Pain Scale – Revised (FPS-R) tool was utilised to assess participants’ pain scores after the finger-guided prostate biopsy.

Results: The participants were aged between 52 and 86 years. Of these, 51.3% did not consume alcohol while 85.9% were non smokers. Participants with diabetes and neurological disorders accounted for 9% each. Additionally, 85.9% had lower urinary tract symptoms (LUTS) with a mean duration of five months, and 85.9% had abnormal digital rectal exam (DRE) findings. Of the participants, 16.7% had undergone a previous prostate biopsy. Only one participant (1.3%) had a normal prostate-specific antigen (PSA) level while the mean PSA level in the study was 53.93 ng/mL. The mean prostate volume was 66.97 cc. On average six prostate punctures were performed per participant with a mean procedure duration of 8.95 minutes. The majority of participants (93.6%) had a pain score ≥ 4 while the average pain score was 5.87.

Conclusion: The average pain score associated with the combined use of intra-rectal lignocaine and oral paracetamol before the prostate biopsy was 5.87, which is above the pain score of ≤ 3; defined as the cut-off pain score of a minimally painful procedure.1 Therefore, this combination does not provide adequate pain control during a prostate biopsy.

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Author Biography

LT Matanhike, University of Zambia

Department of Surgery, School of Medicine, University of Zambia, Zambia