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

Abstract

Outpatient procedures are becoming increasingly common, and one of them is prostate biopsy, which is currently performed using image fusion of magnetic resonance imaging and ultrasound, allowing for highly accurate localization of suspicious areas of injury. Multiple anesthetic techniques have been described for this, with local anesthesia being the most common. However, with the refinement of target-controlled infusion pumps, known as TCI, it is possible to take into account multiple individual parameters such as weight, height, and age, to achieve the desired goal with the least amount of medication administered. This is an observational, descriptive, and prospective clinical trial that seeks to demonstrate the safety of propofol sedation via TCI pump in an office setting in patients who attended the urology service of the CMDLT with an indication for biopsy between July and September, who met the inclusion and exclusion criteria. The adverse effect observed was a decrease in saturation greater than 92%, in 20% of patients. A direct relationship was evidenced between a BMI greater than 28 and the appearance of adverse effects (p 0.03), as well as with higher doses of midazolam above 2.20mg (p 0.03), and a tendency to present adverse effects was observed in patients with risk factors, although the difference was not statistically significant. In conclusion, when performing transperineal fusion prostate biopsy, an outpatient and painful procedure, sedation with propofol in target-controlled infusion is a safe option, with low incidence of adverse effects, rapid recovery, and satisfactory for the patient.