A Comparative Cost Analysis of Local Anesthesia versus Brachial Plexus Block for Complex Hand Surgery

Area of Science:

• Anesthesiology
• Orthopedic Surgery
• Health Economics

Background:

• Local anesthesia (LA) is established as safe and cost-effective for outpatient hand surgeries.
• The economic implications of LA versus regional anesthesia (brachial plexus block) for inpatient operating room hand surgeries remain unclear.
• This study addresses the cost-effectiveness of LA compared to brachial plexus (BP) block for hand surgeries within the main operating room.

Purpose of the Study:

• To compare the anesthesia-related costs of local anesthesia (LA) versus brachial plexus (BP) block for hand surgeries performed in the operating room.
• To analyze secondary outcomes including block performance time, onset, duration, and recovery room time.

Main Methods:

• A cross-sectional study of 70 patients from a prospective controlled trial comparing anesthesia modalities for hand surgery.
• Data collected included anesthesia-related costs, block performance and onset times, anesthesia duration, surgery duration, and recovery room time.

Main Results:

• The mean anesthesia-related cost for LA was $236 ± 30, significantly lower than $435 ± 43 for BP block, representing a $199 cost saving per case.
• Block performance time was substantially shorter for LA (1.3 min) compared to BP block (7.0 min).
• Total anesthesia time was longer for BP block (30.7 ± 16 min) than for LA (17.7 ± 6.7 min).

Conclusions:

• Local anesthesia (LA) offers substantial cost savings compared to brachial plexus (BP) block for complex hand surgeries in the operating room.
• LA reduces major expenses and is a cost-effective modality for health systems.
• Utilizing LA can optimize patient flow and enhance overall cost-effectiveness in hand surgery.