Sedation with Propofol target-controlled infusión for traperineal fusión biopsy of the prostate

Abstract

Prostate biopsy, performed outside the operating room using fusion of MRI and ultrasound images, allows precise lesion localization. Local anesthesia is commonly used, but with the advancement of target-controlled infusion (TCI) pumps, individual parameters such as weight, height, and age can be considered to administer the minimal required amount of medication. This observational, prospective clinical trial aimed to demonstrate the safety of sedation with propofol through TCI pumps in patients who attended the urology service at CMDLT for biopsy between July and September 2024. The observed adverse effect was a decrease in saturation below 92%, seen in 20% of patients. A significant relationship was found between an BMI greater than 28 and the occurrence of adverse effects (p = 0.03), as well as with doses of midazolam above 2.20 mg (p = 0.03). Although there was a trend toward adverse effects in patients with risk factors, the difference was not statistically significant. In conclusion, propofol sedation guided by TCI in transperineal prostate biopsies is a safe option, with few adverse effects, quick recovery, and high patient satisfaction.