Anesth Pain Med.  2017 Apr;12(2):123-131. 10.17085/apm.2017.12.2.123.

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

• Seo KH
• Yoo HS
• Kim HY
• Jeon YS

• KMID: 2379731
• DOI: http://doi.org/10.17085/apm.2017.12.2.123

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.

Keyword

Biopsy; Deep sedation; Meperidine; Propofol; Prostate

MeSH Terms

Anesthesia
Biopsy*
Blood Pressure
Day Care, Medical
Deep Sedation*
Double-Blind Method*
Hemodynamics
Humans
Incidence
Male
Meperidine*
Patient Satisfaction
Propofol
Prostate*
Meperidine
Propofol

Figure

• 

  Fig. 1 CONSORT flow chart of patients enrolled in this study. *All withdrawals were due to the prolongation of the procedure (> 20 min). Group C: propofol group, Group M: propofol and meperidine group.

• 

  Fig. 2 Bispectral index during sedation. Data are presented as mean ± SD. T0: initial monitoring, T5: 5 minutes after initial monitoring, Tend: the end of the procedure. Group C: propofol group, Group M: propofol and meperidine group.

• 

  Fig. 3 Changes in blood pressure, heart rate, saturation during periprocedural periods. Data are presented as mean ± SD. Student’s t-test, *P < 0.05 vs group C, T0: initial monitoring, T5: 5 minutes after initial monitoring, Tend: the end of the procedure; R15, R30, R45, R60: 15, 30, 45, 60 minutes after the procedure, Group C: propofol group, Group M: propofol and meperidine group. SBP: systolic blood pressure, MBP: mean blood pressure, SpO2: peripheral oxygen saturation.

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