Effect of Intraspinal Anaesthesia versus General Anaesthesia on Elderly Male Patients Undergoing Laparoscopic Radical Prostatectomy: A Retrospective Study.

[BACKGROUND] Prostate cancer surgery is gradually increasing amongst the elderly. This study aims to compare the effect of intraspinal anaesthesia with that of general anaesthesia on elderly patients undergoing laparoscopic radical prostatectomy (LRP).

[METHODS] A total of 131 elderly patients receiving laparoscopic radical prostatectomy in our hospital from June 2020 to May 2023 were selected for retrospective analysis. A total of 59 patients receiving intraspinal anaesthesia were included in the observation group. After three patients were excluded, 56 patients were included. A total of 72 patients who received general anaesthesia were classified as the reference group. After two patients were excluded, 70 patients were finally included in the reference group. Perioperative indicators, stress response, P300 (P3) latency and amplitude parameters and adverse reaction incidence were compared between the two groups.

[RESULTS] Operation, anaesthesia onset and anaesthesia recovery times in the observation group were significantly shorter than those in the reference group ( < 0.05). However, no difference was found in anaesthesia observation times between the two groups ( > 0.05). No distinct difference in levels of serum epinephrine (E), norepinephrine (NE) and cortisol (Cor) immediately before skin incision was found between the two groups ( > 0.05). The observation group had significantly lower levels of serum E, NE and Cor than the reference group at 1 h after the beginning of surgery, immediately after surgery and 2 h after surgery ( < 0.05). P3 latency and amplitude parameters did not significantly differ between the two groups before and 12 h after surgery ( > 0.05). The observation group had a significantly lower P3 latency at 1 and 6 h after surgery and significantly higher P3 amplitude parameters than the reference group ( < 0.001). The incidence of adverse reactions did not differ between the observation (8.93%) and reference (18.57%) groups ( > 0.05).

[CONCLUSIONS] In elderly patients, intraspinal anaesthesia can shorten anaesthesia recovery time after LRP, reduce perioperative systemic stress response, and reduce the effect on the brain, which is helpful for patients' recovery after surgery.