• Shinichiro Yoshida, Kohki Nishikawa, Yuki Shimodate, Motohiko Igarashi, and Akiyoshi Namiki.
• Department of Anesthesia, Asahikawa Red Cross Hospital, Asahikawa 070-8530.
• Masui. 2008 May 1; 57 (5): 605-9.

BackgroundOpinions 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.MethodsEighty 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).ResultsSignificantly 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).ConclusionsSpinal 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.

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