**4. Management of the patient before and after the procedure**

In order to safely perform the treatment, the surgeon is advised to follow some recommendations, in accordance with the European and American guidelines:


All patients undergo intra-spinal block with Chirocaine®.

Marcaine® can be used instead of Chirocaine.

If Marcaine is administrated, it is important to begin the procedure from the left lobe of the prostate, because this lobe is above due to the left decubitus of the patient on the device. In order to make the procedure more bearable and to obtain the best cooperation from the patient, Midazolam 0,03 mg/kg administration during the procedure is recommended.

Other benzodiazepine can be used, according with their pharmacocynetic and pharmacodynamic features.

Reportedly, patients have no postoperative pain, except in case of complication. Just in the first two hours after the treatment the patient might complain of confusion and dazzling, but these are considered common consequences of the anaesthetic treatment.

The anaesthetist should be involved pre-operatively, intra-operatively and post-operatively, in order to manage the patient properly before and during the treatment and in order to relieve post-operative pain and anaesthetic side-effects and/or complications.
