Efficacy and Safety of COX-2 Inhibitor Parecoxib for Rigid Cystoscopy-related Pain Management in Male Patients: A Prospective, Randomized and Controlled Study.

Abstract

Using anesthetic gel may not sufficiently exclude pain perception during and after cystoscopy in male patients. To evaluate the analgesic efficacy and safety of intramuscular parecoxib (40 mg) for outpatient-based rigid cystoscopy, we performed a prospective, randomized and controlled study. Consecutive male patients requiring diagnostic cystoscopy in our hospital were divided into group A (1% tetracaine gel, n=50) and group B (parecoxib, n=51) at random. Patients received intramuscular injections of either 2 mL sterile saline in group A or 40 mg parecoxib in group B 30 min before the procedure. Tetracaine gel was injected into the urethra 3 min before the procedure in group A, with patients receiving plain lubricant gel in group B at the same time. Cystoscopy-associated pain levels were evaluated using the Visual Analog Score (VAS) during the procedure. Post-procedure urethral pain and complications were recorded and analyzed. The results showed that male patients experienced significantly less pain in group B than in group A (2.70±1.36 vs. 3.56±1.74, P=0.008). The percentage of patients with dysuria pain was not significantly different between the two groups. In addition, 24 h after cystoscopy, the patients with no previous experience of cystoscopy were more likely to declare urethral pain (59.2% vs. 33.3%, P=0.012, relative risk=1.78). No difference was observed in analgesic-related complications between the two groups. We conclude that intramuscular injection of 40 mg parecoxib may improve comfort for male patients undergoing rigid cystoscopy.