General Anesthesia versus Sedation in Multi ParametricMagnetic Resonance Imaging (mpMRI) TransrectalUltrasound Guided (TRUS) Fusion Targeted Prostate Biopsy:A Prospective, Randomized Study

Abstract

Objectives: Different anesthetic methods have been used in multi-parametric magnetic resonance imaging-guided (mpMRI) transrectal ultrasound guidance (TRUS) fusion-targeted prostate biopsy, but the consensus on the optimal anesthetic approach is not clear. In this study, the anesthesia management, procedural conditions, intraoperative adverse events, complications, discharge criteria, and cancer detection rates of general anesthesia and sedation were compared. Methods: Participants were randomly divided into general anesthesia (GA) and sedation (S) groups. The primary endpoint of the study was the surgical satisfaction score. The incidence of hypoxia, patient satisfaction, cancer detection rate, anesthetic agent consumption, recovery and hospitalization times, and complication rates were all compared as secondary outcomes. Results: There was no significant difference in the incidence of hypoxemia in both groups (Group G:0, Group S:2 patients, p=0.494). While there was no significant difference in surgical satisfaction scores (Group GA: 9.48 vs Group S: 9.23, p=0.353). PC detection rates (p=0.809) and complication rates were similar. Conclusion: With similar surgical conditions, complication incidence, and cancer detection rates, neither anesthesia approach did not provide surgical superiority over the other. The sedation approach, combined with careful monitoring of anesthesia depth, prevented hypoxemia, reduced anesthetic agent consumption, and allowed for faster recovery and discharge, allowing for ambulatory anesthesia.