[Efficacy of spinal anesthesia with small-dose lidocaine in ambulatory prostate biopsy procedures for elderly patients : comparison with propofol anesthesia].

BACKGROUND

Opinions differ as to what is more appropriate anesthetic technique for elderly patients undergoing ambulatory surgery. The objective of this study is to compare the efficacy and safety of spinal anesthesia with small-dose lidocaine and those of propofol general anesthesia in elderly patients undergoing ambulatory prostate biopsy.

METHODS

Eighty ASA physical status I x II patients aged older than 65 year were randomized to receive either spinal anesthesia with 1% hyperbaric lidocaine 1 ml (10 mg) (group L) or general anesthesia with 1.0 mg x kg(-1) of propofol injected at 180 mg x kg(-1) x hr(-1) followed by continuous infusion at 8 mg x kg(-1) x hr(-1) (group P).

RESULTS

Significantly higher incidences of intraoperative hypotension and respiratory depression were found in the group P compared with the group L (P < 0.05). There were no major postoperative side effects, including transient neurologic symptoms and delirious sate, in either group. Both anesthetic techniques resulted in a high rate of patient satisfaction. Total perioperative costs were significantly lower in the group L compared with the group P (P < 0.01).

CONCLUSIONS

Spinal anesthesia with 10 mg of hyperbaric 1% lidocaine may be more preferable to propofol anesthesia in elderly patiens undergoing ambulatory prostate biopsy, with respect to safety and costs.