The effect of different anesthesia techniques on the ratesof being taken into intensive care unit, mortality ratesand costs of geriatric patients undergoing transurethralresection of prostate

Introduction: With the aging global population, the number of elderly people with urinary system diseases is increasing. Due to the demographic shift oriented to the elderly population, the cost of lower urinary tract symptoms due to Benign Prostatic Hyperplasia (BPH) is predicted to increase considerably. Transurethral Prostate Resection (TUR-P) has been accepted as an important treatment modality for small and medium size of BPH. TUR-P may be associated with serious morbidity and even mortality. Generally, regional and general anesthesia is preferred as an anesthetic method. Purpose: The purpose of our study was to evaluate the effect of different anesthesia techniques on the rates of being taken into intensive care unit, mortality rates and costs of geriatric patients undergoing TUR-P. Material and method: The records of 234 patients aged 60 years and older who underwent TUR-P and whom neuro-axial, sedoanalgesia or general anesthesia was performed between 2012 and 2017 in the Urology Department of Gaziantep University Medical Faculty Hospital were evaluated retrospectively. Findings: Out of the 76 patients who had undergone TUR-P with general anesthesia, 30 had preoperative need for intensive care unit, but 2 (6 %) patients were taken in to the intensive care unit. Out of the 151 patients who received neuro-axial anesthesia, 44 were required intensive care unit, but 3 (6.8%) were taken to the intensive care unit. Out of the 7 patients with sedoanalgesia, 4 were preoperatively envisioned to be taken to the intensive care unit and none were taken to the intensive care unit. It was observed that the anesthetic form did not affect the duration of surgery, the number of patients being taken in to the intensive care unit, length of intensive care unit stay, the length of hospital stay, the duration of the stay in hospital, the mortality and the cost. It was also observed that for patients with a high Charlson Comorbidity Index (CCI), the duration of stay in the hospital and in the intensive care unit increases and so does the cost. It was detected that ASA scores were not as significant as CCI. It is determined that the high number of additional diseases and the high rate of CCI increase the cost. Result: It has been concluded that 3 anesthetic methods applied to geriatric patients in TUR-P surgery do not affect the mortality, cost and the rates of being taken into intensive care unit, however, neuro-axial anesthesia is preferred more in recent years. Key Words: Geriatric, TUR-P, Mortality, Anesthetic techniques, Cost