Nowadays, TRUS biopsy become one of the most popular tests for diagnosis of prostate cancer. This procedure causes pain to the patients who does not received the sedative drugs or analgesic drugs. There are many ways to reduce pain and inconvenience for the patients, such as intravenous propofol, intravenous fentanyl etc. In Siriraj hospital, anesthesiologists usually give intravenous propofol with intravenous opioids but the visual analogue score after this procedure was average at 0.9-2.9. Furthermore, some systematic reviews have shown that there was no difference in pain score between periprostatic nerve block plus opioid and periprostatic nerve block only. So, this study is to find out whether opioids is need for TRUS biopsy.

Inclusion Criteria:

• Age over 18 year
• Patient American society of anesthesiology physical status I-III.
• Scheduled for Transrectal ultrasound-guided prostate biopsy
• BMI equal to or less than 30 kg/cm2

Exclusion Criteria:

• Known hypersensitivity to propofol or fentanyl
• History of bleeding tendency
• Known case of active anal or rectal disease
• Unable to rate pain score
• History of drug abuse
• Chronic opioid use