title: A comparison of spinal anesthesia with small-dose lidocaine and general anesthesia with fentanyl and propofol for ambulatory prostate biopsy procedures in elderly patients.
abstract: OBJECTIVE
  To compare operating conditions, intraoperative adverse events, recovery profiles, postoperative adverse effects, patient satisfaction, and costs of small-dose lidocaine spinal anesthesia with those of general anesthesia using fentanyl and propofol for elderly outpatient prostate biopsy.
  
  
  METHODS
  Prospective, randomized, blind study.
  
  
  METHODS
  Outpatient anesthesia unit at a municipal hospital.
  
  
  METHODS
  80 ASA physical status I and II patients, aged 65 to 80 years, scheduled for outpatient prostate biopsy.
  
  
  METHODS
  Patients were assigned to receive either spinal anesthesia with 10 mg of hyperbaric 1% lidocaine (L group, n=40) or anesthetic induction with fentanyl 1 microg.kg-1 IV and 1.0 mg.kg-1 propofol injected at 90 mg.kg-1.h-1, followed by continuous infusion at 6 mg.kg-1.h-1 (F/P group, n=40).
  
  
  RESULTS
  Both anesthetic techniques provided acceptable operating conditions for the surgeon. However, a significantly higher frequency of intraoperative hypotension was found in the F/P group than in the L group (P<0.05). Time to home readiness was shorter in the F/P group (P<0.05). Both techniques had no major postoperative adverse effects and resulted in a high rate of patient satisfaction. Total costs were significantly lower in the L group than in the F/P group (P<0.01).
  
  
  CONCLUSIONS
  Spinal anesthesia with 10 mg of hyperbaric 1% lidocaine may be a more suitable alternative to general anesthesia with fentanyl and propofol for ambulatory elderly prostate biopsy in terms of safety and costs.
authors.affiliation: Department of Anesthesiology, Sapporo Medical University, School of Medicine, Sapporo, 060-8543 Hokkaido, Japan. nkouki@sapmed.ac.jp
authors.forename: Kohki
authors.initials: K
authors.lastname: Nishikawa
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yoshida
authors.forename: Yuki
authors.initials: Y
authors.lastname: Shimodate
authors.forename: Motohiko
authors.initials: M
authors.lastname: Igarashi
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Namiki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000704:Analysis of Variance; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000191:economics / Q000379:methods*; D000775:Anesthesia, Spinal / Q000191:economics / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects* / Q000191:economics; D001706:Biopsy / Q000379:methods; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects* / Q000191:economics; D008297:Male; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D016037:Single-Blind Method
chemical_list: D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D008012:Lidocaine; D005283:Fentanyl; D015742:Propofol