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Local anaesthesia better, cheaper than general anaesthesia

10 May 2018

The use of local anaesthesia is not only economical but also appears to be better than general anaesthesia techniques, suggests a recent study.

Fifty-one studies were included in the analysis, of which 41 directly examined outcomes in procedures performed under local and general anaesthesia, and none found a significant difference in outcomes. Adverse effects were measured in 41 studies.

Fifteen of the 51 studies (36.6 percent) reported significantly better outcomes between the two techniques, but only two (4.9 percent) showed significantly improved outcomes with use of general anaesthesia.

There were 15 out of 36 studies (41.7 percent) reporting that use of local anaesthesia resulted in fewer adverse events. In addition, all 13 studies that examined costs (100 percent) found significantly lower costs with use of local anaesthesia.

“These data cannot be seamlessly applied to all cases of cutaneous surgery,” the investigators said.

This retrospective analysis involved case comparison studies from other specialties comparing outcomes, risks and/or costs in local vs general anaesthesia. Literature from dermatology and other specialties were also reviewed.

“There is a paucity of data providing direct comparison of outcomes, complications and costs between general and local anaesthesia in cutaneous surgery,” the investigators said.

A 2017 review reported potential risks and side effects with use of local anaesthesia in cutaneous surgery. Park and Sharon noted that appropriate selection and utilization of local anaesthesia, as well as knowledge of the means to prevent and address these risks, can influence surgical outcomes, patient satisfaction and safety, and ultimately patient experience in the dermatology clinic. [Dermatol Surg 2017;43:173-187]

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