Selective Spinal Anesthesia versus Intravenous Propofol in Transrectal Ultrasound-Guided Prostate Biopsy
Petchara Sundarathiti MD*, Chomchaba Sirinan MD*, Rattaphol Seangrung MD*, Jittiya Watcharotayangul MD*, Wannipa Sithamwilai RN*
Affiliation : * Department of Anesthesiology, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
Background : Selective spinal anesthesia (SSA) focuses on the use of minimal doses of intrathecal agents with
greater precision and selectivity so that return of function occurs rapidly.
Objective : The authors compared the efficacy of 1.25 mg of hyperbaric bupivacaine intrathecally with propofol
anesthesia in terms of hemodynamic stability, surgical conditions and ability to bypass the post anesthetic
care unit (PACU).
Material and Method: Seventy male patients, 45-85 years old, ASA physical status I-III, were randomly
allocated into two groups. Group 1 (n = 35) received intrathecal 1.25 mg hyperbaric bupivacaine plus
patient’s cerebrospinal fluid 0.75 ml. Group 2 (n = 35) received propofol 1-1.5 mg/kg IV bolus dose and 6-10
mg/kg/hr infusion to maintain surgical anesthesia.
Results : The patients in group 1 had adequate anesthesia and were able to walk and bypass the PACU
(100%). The need of supplemental oxygen and airway maneuver, the incidence of hypotension and bradycardia
were found only in group 2. The surgical conditions were rated as excellent 100% in group 1 and 57.1% in
group 2.
Conclusion : SSA is superior to propofol anesthesia in terms of hemodynamic stability, surgical conditions and
recovery profiles. Even elderly patients were able to walk out from the operating theatre immediately after the
procedure.
Keywords : Selective spinal anesthesia (SSA), Ambulatory anesthesia, prostate biopsy
