Trends in the Use of Neuraxial vs. General Anaesthesia for Transurethral Resection of the Prostate
- 1Baylor College of Medicine School of Medicine, Department of Student Affairs, Houston, TX, USA
- 2Baylor College of Medicine, Department of Anaesthesiology, Houston, TX, USA
Abstract
Objective: Historically, neuraxial anaesthesia (NA) was preferred for transurethral resection of the prostate (TURP) to allow monitoring for TURP syndrome, but modern surgical techniques have largely eliminated this risk. We aimed to characterise trends in anaesthesia utilisation for TURP over a 15-year period and to identify patient factors associated with anaesthetic technique selection.
Methods: We performed a retrospective cohort study of patients undergoing primary TURP using the ACS-NSQIP database (2009-2023). Multivariable logistic regression identified predictors of the use of general anaesthesia (GA) versus NA. Subgroup analyses examined trends by patient health status and age.
Results: Of 73,214 patients identified, GA utilisation increased significantly from 69.9% in 2009 to 88.8% in 2023 (P < 0.001). In multivariable analysis, each successive year was associated with a 15% increase in the odds of receiving GA [odds ratio (OR) 1.15, 95% confidence interval (CI) 1.14-1.15]. Black patients (OR 1.65, 95% CI 1.47-1.87) had higher odds of GA than White patients, and Hispanic patients (OR 1.51, 95% CI 1.38-1.64) had higher odds of GA than non-Hispanic patients. Conversely, older age, chronic obstructive pulmonary disease (OR 0.77, 95% CI 0.71-0.84), and diabetes (OR 0.88, 95% CI 0.84-0.93) were associated with decreased GA use. The shift towards GA was significantly more pronounced among medically complex patients (American Society of Anesthesiologists 3-4) than among less medically complex patients (P=0.005).
Conclusion: The anaesthetic management of TURP has evolved over the last 15 years, and GA has further solidified its status as the dominant modality. This evolution likely reflects the diminished risk of TURP syndrome, allowing practice to be driven by airway control and efficiency rather than by historical safety constraints.
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BibTeX
@article{gorchs2026trends,
title = {{Trends in the Use of Neuraxial vs. General Anaesthesia for Transurethral Resection of the Prostate}},
author = {Roman Gorchs and Vaidya Parthasarathy and Evan Burchfiel and Nitin Prabakaran and Ali Khalifa},
journal = {Turkish Journal of Anaesthesiology and Reanimation},
year = {2026},
month = oct,
doi = {10.4274/tjar.2026.262690},
url = {https://doi.org/10.4274/tjar.2026.262690},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Trends in the Use of Neuraxial vs. General Anaesthesia for Transurethral Resection of the Prostate
AU - Roman Gorchs
AU - Vaidya Parthasarathy
AU - Evan Burchfiel
AU - Nitin Prabakaran
AU - Ali Khalifa
PY - 2026
DA - 2026/10/30
JO - Turkish Journal of Anaesthesiology and Reanimation
DO - 10.4274/tjar.2026.262690
UR - https://doi.org/10.4274/tjar.2026.262690
AB - Objective: Historically, neuraxial anaesthesia (NA) was preferred for transurethral resection of the prostate (TURP) to allow monitoring for TURP syndrome, but modern surgical techniques have largely eliminated this risk. We aimed to characterise trends in anaesthesia utilisation for TURP over a 15-year period and to identify patient factors associated with anaesthetic technique selection. Methods: We performed a retrospective cohort study of patients undergoing primary TURP using the ACS-NSQIP database (2009-2023). Multivariable logistic regression identified predictors of the use of general anaesthesia (GA) versus NA. Subgroup analyses examined trends by patient health status and age. Results: Of 73,214 patients identified, GA utilisation increased significantly from 69.9% in 2009 to 88.8% in 2023 (P < 0.001). In multivariable analysis, each successive year was associated with a 15% increase in the odds of receiving GA [odds ratio (OR) 1.15, 95% confidence interval (CI) 1.14-1.15]. Black patients (OR 1.65, 95% CI 1.47-1.87) had higher odds of GA than White patients, and Hispanic patients (OR 1.51, 95% CI 1.38-1.64) had higher odds of GA than non-Hispanic patients. Conversely, older age, chronic obstructive pulmonary disease (OR 0.77, 95% CI 0.71-0.84), and diabetes (OR 0.88, 95% CI 0.84-0.93) were associated with decreased GA use. The shift towards GA was significantly more pronounced among medically complex patients (American Society of Anesthesiologists 3-4) than among less medically complex patients (P=0.005). Conclusion: The anaesthetic management of TURP has evolved over the last 15 years, and GA has further solidified its status as the dominant modality. This evolution likely reflects the diminished risk of TURP syndrome, allowing practice to be driven by airway control and efficiency rather than by historical safety constraints.
SN - 2667-677X
SN - 2667-6370
ER -