A comparative study among three techniques of general anesthesia for ultrasound-guided transrectal prostate biopsy.
OBJECTIVE
Ultrasound-guided transrectal prostate biopsy is a reference in the diagnosis of prostate neoplasias. The higher the number of samples, the greater is the pain and discomfort. The objective of this study was to compare three anesthetic techniques in this group of patients.


METHODS
Forty-five patients were included in this study. Patients were divided into three groups: 1 - Propofol; 2 - Propofol + Prostatic Plexus Block; 3 - Propofol + Fentanyl. Patients were monitored with non-invasive blood pressure, continuous electrocardioscopy, pulse oximetry (SpO₂), and Bispectral Index. Patients did not receive pre-anesthetic medication. Intraoperative and postoperative hemodynamic parameters, intraoperative bispectral index, and postoperative visual analogue scale (VAS) and the use of dypirone to treat postoperative pain were evaluated.


RESULTS
A significant difference among the three groups was not observed for: anthropometric parameters, amount of propofol, number of fragments, and duration of the exam. Hemodynamic parameters and SpO₂ presented similar behavior in all three groups. In group 1, the pain evaluated by the VAS was more severe and required more dypirone than in the other groups.


CONCLUSIONS
Sedation with propofol alone for biopsy is associated with greater postoperative pain and discomfort than in prostatic plexus block or systemic fentanyl. Besides hypnosis, intraoperative analgesia is required to guarantee postoperative comfort.
Barbosa
Ricardo Antônio Guimarães
RA
Faculdade de Medicina da Universidade de São Paulo, FMUSP, Brazil.
da Silva
Camerine Domingues
CD
Torniziello
Mary Yumi Takei
MY
Cerri
Luciana Mendes de Olivera
LM
Carmona
Maria José Carvalho
MJ
Malbouisson
Luiz Marcelo Sá
LM
D000368:Aged; D000768:Anesthesia, General / Q000379:methods*; D019162:Anesthetics, Combined / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D001707:Biopsy, Needle / Q000379:methods*; D005283:Fentanyl / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D015742:Propofol / Q000627:therapeutic use*; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012007:Rectum; D014463:Ultrasonography
D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D005283:Fentanyl; D015742:Propofol