Local Anesthesia Alone for Postaxial Polydactyly Surgery in Infants

Area of Science:

• Pediatric Surgery
• Anesthesiology

Background:

• Postaxial polydactyly type B requires surgical excision to prevent long-term complications.
• While general anesthesia (GA) is common, local anesthesia (LA) in infancy is a safe alternative.

Purpose of the Study:

• To compare surgical outcomes, costs, and time efficiency between LA and GA for postaxial polydactyly type B excision.
• To advocate for a shift in management towards LA in early infancy.

Main Methods:

• Retrospective review of 91 infants under 12 months undergoing polydactyly excision.
• Comparison of procedure cost, operating time, length of stay (LOS), and discharge time between LA and GA groups.
• Stepwise forward regression to identify predictors of total costs.

Main Results:

• No significant difference in operating time between LA and GA groups (11.53 ± 4.36 minutes).
• LA group showed significantly shorter LOS (2.5 vs 3.5 hours), quicker discharge (32 vs 65 minutes), and lower costs ($2803 vs $6067 USD).
• Two minor complications occurred, one in each anesthesia group.

Conclusions:

• Surgical excision of postaxial polydactyly type B using LA alone is significantly more cost-effective, with shorter LOS and discharge times.
• LA is a quick, economical, and safe alternative to GA for this procedure in infants, minimizing risks associated with GA.