title: A comparative study among three techniques of general anesthesia for ultrasound-guided transrectal prostate biopsy.
abstract: 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.
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, FMUSP, Brazil.
authors.forename: Ricardo Antônio Guimarães
authors.initials: RA
authors.lastname: Barbosa
authors.forename: Camerine Domingues
authors.initials: CD
authors.lastname: da Silva
authors.forename: Mary Yumi Takei
authors.initials: MY
authors.lastname: Torniziello
authors.forename: Luciana Mendes de Olivera
authors.initials: LM
authors.lastname: Cerri
authors.forename: Maria José Carvalho
authors.initials: MJ
authors.lastname: Carmona
authors.forename: Luiz Marcelo Sá
authors.initials: LM
authors.lastname: Malbouisson
mesh_terms: 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
chemical_list: D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D005283:Fentanyl; D015742:Propofol