Comparative Effectiveness of Propofol-Sufentanil vs Propofol-Fentanyl in Elderly Patients Undergoing Transurethral Resection of the Prostate.

Objective: The aim of this study is to compare the anesthetic effect and cognitive function impact of propofol-sufentanil (PS) versus propofol-fentanyl (PF) in elderly patients undergoing transurethral resection of the prostate (TURP) under general anesthesia (GA). Methods: This is a retrospective cohort study conducted in First People's Hospital of Yongkang City. They included 98 patients aged 65 and above who underwent TURP under GA between October 2023 and March 2025. 49 patients who received PS were matched with a cohort of propofol-fentanyl (PF) in a 1:1 ratio. Compare the hemodynamic parameters (heart rate (HR) and mean arterial pressure (MAP)) of two groups at 30 minutes before anesthesia induction (T0), after anesthesia completion (T1), at the time of skin incision (T2), at the end of surgery (T3), at the postanesthesia care unit (PACU) (T4), 15 minutes after PACU arrival (T5), and 30 minutes after PACU arrival (T6). Compare two perioperative indicators (anesthesia onset time, postoperative awakening time, and extubation time). Compare the pain visual analogue scale (VAS) scores of two groups at three, 12, and 24 hours after surgery. And the Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the number of patients with cognitive impairment at six, 24, and 72 hours after surgery in two groups. Compare the incidence of adverse reactions within 72 hours after surgery between two groups. Results: Compared with the PF group, the PS group had more stable hemodynamics during T2-T5 (P<0.05); VAS scores were lower at 12 and 24 hours postoperatively (P<0.05); The anesthesia onset time, postoperative awakening time, and extubation time of the PS group were significantly shorter than those of the PF group (P<0.05); The incidence of cognitive dysfunction was lower at six and 24 hours after surgery (P<0.05). However, there was no significant difference in the incidence of various complications between the two groups (P>0.05). Conclusion: PS is more effective for TURP anesthesia and has a better protective effect on early postoperative cognitive function.