Advantages of ultrasound-guided caudal epidural block over TIVA for transrectal ultrasound guided transrectal prostate biopsy / 中国医师杂志

ABSTRACT

Objective To compare the safety and efficacy of the caudal block and Total Intravenous Anesthesia (TIVA) for transrectal ultrasound (TRUS) guided prostate biopsy.Methods 60 elderly patients with transrectal ultrasound guided transperineal prostate biopsy were randomized into Group A and Group B.Patients in Group A received ultrasound guided caudal block (0.33％ ropivacaine 15 ml) and patients in Group B received TIVA.In operation room (T1),immediately before operation (T2) and at the end of operation (T3),mean artery pressure (MAP),heart rate (HR),breathing rate (BR) and pulse oxygen saturation (SpO2) were recorded.The patients in two groups were rated the level of mini-mental state examination (MMES) at 2 h,8 h and 24 h after operation.Complications during the whole study period were also evaluated.Results The values of MAP,HR and BR of T1 in group B were significantly lower than those at T2 (P＜0.05),and were lower than those in the group A (P ＜0.05).The MMSE value in group A [2 h (25.66 ± 1.71) and 8 h (26.13 ± 1.52)] was significantly higher than that in group B [2 h (27.96 ± 1.71) and 8 h (29.01 ± 0.77)] at after operation (P ＜ 0.05).The rate of usage of ephedrine (13％) and assisted ventilation (20％) in group B was higher.No significant differences were detected in side effects between the two groups.Conclusions Caudal block provides better anesthesia than TIVA for TRUS guided prostate biopsy without an increase of side effects,and it may be safely used during ambulatory surgery.