Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure

Area of Science:

• Health Economics
• Anesthesiology
• Surgical Procedures

Background:

• Health economics research remains underexplored, yet cost savings are increasingly vital.
• Implementing strict criteria for cost-saving measures in healthcare is essential.

Purpose of the Study:

• To conduct a cost-effectiveness analysis comparing spinal anesthesia and local anesthesia with sedation for loop colostomy closure.
• Evaluate the economic and clinical efficiency of two anesthesia methods for a specific surgical procedure.

Main Methods:

• A randomized clinical trial involving 50 patients undergoing loop colostomy closure.
• Patients were randomized to receive either spinal anesthesia (n=25) or local anesthesia plus sedation (n=25).
• Analysis included operational duration, recovery room time, pain, complications, hospital stay, and direct medical costs using a decision tree model.

Main Results:

• Local anesthesia plus sedation showed shorter operation times (105 vs. 146 min) and significantly reduced post-anesthesia recovery room time (36.8 vs. 145 min).
• This group also experienced lower immediate postoperative pain and fewer complications (P=0.209).
• Mean spending per patient was substantially lower (R$ 2,665.57 vs. R$ 5,038.05), with an incremental cost-effectiveness ratio of R$ -474.78, indicating cost savings.

Conclusions:

• Loop colostomy closure under local anesthesia plus sedation is an effective and dominant strategy.
• This approach offers significant cost savings and improved patient outcomes compared to spinal anesthesia for this procedure.