MRI-ultrasound fusion prostate biopsy is a minimally invasive procedure requiring optimal anesthesia to ensure patient comfort, procedural precision, and rapid recovery. This study compares spinal anesthesia (SA) and general inhalational anesthesia with a laryngeal mask airway (GA-LMA), focusing on procedural success, recovery outcomes, cost-effectiveness, and diagnostic accuracy.

A retrospective cohort study was conducted on 80 patients who underwent MRI-ultrasound fusion prostate biopsy at Chinese General Hospital from 2023 to 2024. Patients received either SA or GA-LMA. Key metrics, including procedural success, hemodynamic stability, recovery time, and cost efficiency, were evaluated using t-tests and chi-square tests.

Procedural success rates were similar between the two groups. Spinal anesthesia demonstrated superior cost efficiency, better hemodynamic stability, and lower rates of postoperative nausea and vomiting (PONV). Conversely, GA-LMA was associated with shorter procedural times and faster discharge readiness, albeit at higher costs. Both techniques provided equivalent diagnostic accuracy.

Spinal anesthesia offers a cost-efficient, stable, and safe option for MRI-ultrasound fusion prostate biopsy, making it particularly suitable for resource-limited settings. On the other hand, GA-LMA is advantageous for rapid turnover and discharge readiness, making it ideal for high-volume centers. Tailoring anesthesia choice to patient needs and institutional priorities is essential for optimizing outcomes.