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 Study 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. Design Prospective, randomized, blind study. Setting Outpatient anesthesia unit at a municipal hospital. Patients 80 ASA physical status I and II patients, aged 65 to 80 years, scheduled for outpatient prostate biopsy. Interventions 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 μ g · 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). Measurements and Main 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 P P 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.