Objective To investigate the effects of different anesthesia methods on perioperative circulation and postoperative recovery in elderly patients with benign prostatic hyperplasia (BPH) undergoing blue laser vaporization of the prostate.

Methods Clinical data of BPH patients who underwent blue laser prostate vaporization at Xianyang Central Hospital from July 2022 to June 2025 were retrospectively collected. Patients were divided into three groups according to anesthesia method: general anesthesia (GA) group, spinal anesthesia (SA) group, and non-intubated intravenous anesthesia (NIVA) group. Perioperative circulation indicators and postoperative recovery indicators were compared among the three groups.

Results A total of 265 BPH patients were included, with 85 in the GA group, 100 in the SA group, and 80 in the NIVA group. Compared with the NIVA and SA groups, the GA group exhibited significantly lower mean arterial pressure (MAP) at the time of unconsciousness during anesthesia induction, a more pronounced decrease in heart rate at the end of surgery, longer length of stay in the post-anesthesia care unit (PACU), longer time to postoperative diet recovery, and lower Steward recovery scores (P < 0.05). Compared with the GA and SA groups, the NIVA group had earlier time to postoperative ambulation, shorter time to diet recovery, first flatus time and postoperative hospital stay, as well as lower hospitalization cost and incidence of postoperative complication, accompanied by higher QoR-15 scores on the first day ofter the operation (P < 0.05).

Conclusion For elderly BPH patients undergoing blue laser prostate vaporization, NIVA provides better hemodynamic stability, rapid postoperative recovery and lower incidence of complications, which can be selected as the preferred anesthetic method.

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