• Kohki Nishikawa, Shinichiro Yoshida, Yuki Shimodate, Motohiko Igarashi, and Akiyoshi Namiki.
• Department of Anesthesiology, Sapporo Medical University, School of Medicine, Sapporo, 060-8543 Hokkaido, Japan. nkouki@sapmed.ac.jp
• J Clin Anesth. 2007 Feb 1;19(1):25-9.

Study ObjectiveTo 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.DesignProspective, randomized, blind study.SettingOutpatient anesthesia unit at a municipal hospital.Patients80 ASA physical status I and II patients, aged 65 to 80 years, scheduled for outpatient prostate biopsy.InterventionsPatients 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).Measurements And Main ResultsBoth 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).ConclusionsSpinal 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.

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