{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:15:40Z","timestamp":1790806540449,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T00:00:00Z","timestamp":1627603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether the addition of inhaled methoxyflurane to periprostatic infiltration of local anaesthetic (PILA) during transrectal ultrasonography\u2010guided prostate biopsies (TRUSBs) improved pain and other aspects of the experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>We conducted a multicentre, placebo\u2010controlled, double\u2010blind, randomized phase 3 trial, involving 420 men undergoing their first TRUSB. The intervention was PILA plus a patient\u2010controlled device containing either 3\u2009mL methoxyflurane, or 3\u2009mL 0.9% saline plus one drop of methoxyflurane to preserve blinding. The primary outcome was the pain score (0\u201310) reported by the participant after 15\u2009min. Secondary outcomes included ratings of other aspects of the biopsy experience, willingness to undergo future biopsies, urologists\u2019 ratings, biopsy completion, and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean (SE) pain scores 15\u2009min after TRUSB were 2.51 (0.22) in those assigned methoxyflurane vs 2.82 (0.22) for placebo (difference 0.31, 95% confidence interval [CI] \u22120.75 to 0.14;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.18). Methoxyflurane was associated with better scores for discomfort (difference \u22120.48, 95% CI \u22120.92 to \u22120.03;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.035, adjusted [adj.]\n                      <jats:italic>P<\/jats:italic>\n                      = 0.076), whole experience (difference \u22120.50, 95% CI \u22120.92 to \u22120.08;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.021, adj.\n                      <jats:italic>P<\/jats:italic>\n                      = 0.053), and willingness to undergo repeat biopsies (odds ratio 1.67, 95% CI 1.12\u20132.49;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.01) than placebo. Methoxyflurane resulted in higher scores for drowsiness (difference +1.64, 95% CI 1.21\u20132.07;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001, adj.\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) and dizziness (difference +1.78, 95% CI 1.31\u20132.24;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001, adj.\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) than placebo. There was no significant difference in the number of \u2265 grade 3 adverse events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found no evidence that methoxyflurane improved pain scores at 15\u2009min, however, improvements were seen in patient\u2010reported discomfort, overall experience, and willingness to undergo repeat biopsies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.15552","type":"journal-article","created":{"date-parts":[[2021,7,17]],"date-time":"2021-07-17T13:29:19Z","timestamp":1626528559000},"page":"591-600","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["\u2018Pain\u2010free TRUS B\u2019: a phase 3 double\u2010blind placebo\u2010controlled randomized trial of methoxyflurane with periprostatic local anaesthesia to reduce the discomfort of transrectal ultrasonography\u2010guided prostate biopsy (ANZUP 1501)"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4094-401X","authenticated-orcid":false,"given":"Dickon","family":"Hayne","sequence":"first","affiliation":[{"name":"UWA Medical School University of Western Australia  Perth WA Australia"},{"name":"Fiona Stanley Hospital  Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Grummet","sequence":"additional","affiliation":[{"name":"Alfred Health Central Clinical School Monash University  Melbourne Vic. Australia"},{"name":"Department of Surgery Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Espinoza","sequence":"additional","affiliation":[{"name":"NHMRC Clinical Trials Centre  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3920-994X","authenticated-orcid":false,"given":"Steve P.","family":"McCombie","sequence":"additional","affiliation":[{"name":"UWA Medical School University of Western Australia  Perth WA Australia"},{"name":"Fiona Stanley Hospital  Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venu","family":"Chalasani","sequence":"additional","affiliation":[{"name":"Sydney Adventist Hospital  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3630-8141","authenticated-orcid":false,"given":"Kate S.","family":"Ford","sequence":"additional","affiliation":[{"name":"NHMRC Clinical Trials Centre  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Frydenberg","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Vic. Australia"},{"name":"Cabrini Institute Cabrini Health  Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3118-1655","authenticated-orcid":false,"given":"Peter","family":"Gilling","sequence":"additional","affiliation":[{"name":"Tauranga Urology Research  Tauranga New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Gordon","sequence":"additional","affiliation":[{"name":"Canterbury Urology Research Trust  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7848-9537","authenticated-orcid":false,"given":"Cynthia","family":"Hawks","sequence":"additional","affiliation":[{"name":"UWA Medical School University of Western Australia  Perth WA Australia"},{"name":"Fiona Stanley Hospital  Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Konstantatos","sequence":"additional","affiliation":[{"name":"Alfred Health Central Clinical School Monash University  Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Nixon","sequence":"additional","affiliation":[{"name":"Cardinal Points Research  Whangarei New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Consumer Advisory Panel, Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP)  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1409-9171","authenticated-orcid":false,"given":"Manish I.","family":"Patel","sequence":"additional","affiliation":[{"name":"Discipline of Surgery Westmead Hospital University of Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3357-1216","authenticated-orcid":false,"given":"Shomik","family":"Sengupta","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Vic. 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