The effects of meperidine in patients undergoing deep sedation for transrectal ultrasound-guided prostate biopsy: a randomized, controlled, double-blind study

ABSTRACT

BACKGROUND: The transrectal ultrasound-guided prostate biopsy (TRUS-PBx) is one of the most common procedures among day care center based urologic procedures. Our aim was to determine if pretreatment with meperidine could improve the quality of anesthesia in patients undergoing deep sedation for TRUS-PBx. METHODS: Sixty male patients (30–80 years; American Society of Anesthesiologists physical status class I or II) scheduled for TRUS-PBx were allocated randomly into two groups. After pretreatment with normal saline (Group C) or intravenous (i.v.) meperidine 0.5 mg/kg (Group M), sedation was induced with i.v. propofol 1.5 mg/kg. Additional doses of i.v. propofol 0.5 mg/kg were administered upon patient movement. During the procedure, hemodynamic variables, patient movement, and the bispectral index were measured. After the procedure, the mean modified observer's assessment of alertness/sedation score (MOASS), postprocedural pain, side effects, and patient satisfaction were evaluated. RESULTS: During the procedure, patient movement was not significantly different between the two groups, but Group M required a significantly lower total propofol dose compared to that of Group C (P = 0.036). After the procedure, the MOASS was comparable between the two groups (P = 0.055), but Group M patients experienced significantly less postprocedural pain (P = 0.012), lower systolic and diastolic blood pressure at 45 (P = 0.044 and P = 0.014) and 60 minutes (P < 0.001 and P = 0.006), and lower incidence of tenesmus than Group C (P = 0.020). CONCLUSIONS: Meperidine can be used as a safe, effective analgesic with deep sedation for patients undergoing TRUS-PBx.