title: Efficacy and cost analysis of transrectal ultrasound-guided prostate biopsy under monitored anesthesia.
abstract: Sedation may result in reduction in pain during transrectal ultrasound (TRUS)-guided prostate biopsies. We aimed to evaluate the efficacy and safety of a combination of propofol and remifentanil infusion during TRUS-guided prostate biopsy and the related increases in health care costs. From January to September 2010, 100 men undergoing a transrectal prostate biopsy were randomized into two groups. In Group 1, 50 patients received a combined infusion of propofol and remifentanil; in Group 2, 50 patients received lidocaine jelly. After TRUS-guided biopsies were performed, pain and patient satisfaction were evaluated by a 10-point visual analog scale (VAS), and a cost-related patient satisfaction questionnaire was completed by all patients. Patients were also asked whether they would be willing to undergo repeat biopsy by the same method. Patients in Group 1 showed a significantly lower VAS score than those in Group 2 (mean VAS score: 0.9±1.1 versus 6.3±2.5; P<0.001). In addition, the patient satisfaction scale was significantly higher in Group 1 (P=0.002). Although the overall cost was significantly higher in Group 1 (P=0.006), patient satisfaction scales considering cost were also higher in this group (P=0.009). A combination of propofol and remifentanil is a safe and effective way to decrease patient pain and increase patient satisfaction during TRUS-guided prostate biopsy. Although the costs were higher in the group that received sedation, as expected, the patients exhibited heightened satisfaction and willingness to repeat biopsies by the same method.
authors.affiliation: Department of Urology, Korea University School of Medicine, Korea University Robotic Urologic Surgery Center, Korea University Hospital, Seoul 136-705, Korea.
authors.forename: Sung Gu
authors.initials: SG
authors.lastname: Kang
authors.forename: Bum Sik
authors.initials: BS
authors.lastname: Tae
authors.forename: Sam Hong
authors.initials: SH
authors.lastname: Min
authors.forename: Young Hwii
authors.initials: YH
authors.lastname: Ko
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Kang
authors.forename: Jeong Gu
authors.initials: JG
authors.lastname: Lee
authors.forename: Je Jong
authors.initials: JJ
authors.lastname: Kim
authors.forename: Jun
authors.initials: J
authors.lastname: Cheon
mesh_terms: D000758:Anesthesia; D018686:Anesthetics, Intravenous / Q000191:economics*; D001707:Biopsy, Needle / Q000191:economics; D003365:Costs and Cost Analysis; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010880:Piperidines / Q000008:administration & dosage / Q000191:economics*; D015742:Propofol / Q000008:administration & dosage / Q000191:economics*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D012007:Rectum; D000077208:Remifentanil; D011795:Surveys and Questionnaires; D014463:Ultrasonography
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol