Department of Anesthesiology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Asian J Androl. 2024 Jul 1;26(4):409-414. doi: 10.4103/aja202385. Epub 2024 Feb 20.
This study aims to conduct a cost-effectiveness analysis of three different anesthesia strategies, namely chatting while under local anesthesia (Chat-LA), total intravenous anesthesia (TIVA), and general anesthesia with laryngeal mask airway (GA-LMA), employed in transperineal magnetic resonance imaging (MRI)/ultrasound (US) fusion prostate biopsy (TP-MUF-PB). A retrospective study was conducted involving 1202 patients who underwent TP-MUF-PB from June 2016 to April 2023 at The First Affiliated Hospital of Soochow University (Suzhou, China). Clinical data and outcomes, including total costs, complications, and quality-adjusted life years (QALYs), were compared. Probability sensitivity and subgroup analyses were also performed. Chat-LA was found to be the most cost-effective option, outperforming both TIVA and GA-LMA. However, subgroup analyses revealed that in younger patients (under 65 years old) and those with smaller prostate volumes (<40 ml), TIVA emerged as a more cost-effective strategy. While Chat-LA may generally be the most cost-effective and safer anesthesia method for TP-MUF-PB, personalization of anesthesia strategies is crucial, considering specific patient demographics such as age and prostate volume.
本研究旨在对三种不同麻醉策略进行成本效益分析，这三种策略分别为局部麻醉下聊天（Chat-LA）、全凭静脉麻醉（TIVA）和喉罩气道全身麻醉（GA-LMA），用于经会阴磁共振成像（MRI）/超声（US）融合前列腺活检（TP-MUF-PB）。这是一项回顾性研究，共纳入了 1202 例于 2016 年 6 月至 2023 年 4 月在苏州大学附属第一医院（苏州，中国）接受 TP-MUF-PB 的患者。比较了包括总费用、并发症和质量调整生命年（QALYs）在内的临床数据和结局。还进行了概率敏感性和亚组分析。结果显示，Chat-LA 是最具成本效益的选择，优于 TIVA 和 GA-LMA。然而，亚组分析显示，在年龄较小（<65 岁）和前列腺体积较小（<40ml）的患者中，TIVA 是一种更具成本效益的策略。虽然 Chat-LA 可能是 TP-MUF-PB 的最具成本效益和最安全的麻醉方法，但考虑到年龄和前列腺体积等特定患者特征，需要对麻醉策略进行个体化处理。
