Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Systematic Review

Perioperative costs of local or regional anesthesia versus general anesthesia in the outpatient setting: a systematic review of recent literature

Custos perioperatórios de anestesia local ou regional versus anestesia geral em ambiente ambulatorial: uma revisão sistemática da literatura recente

Valérie Graff, Luca Gabutti, Giorgio Treglia, Mariarosa Pascale, Luciano Anselmi, Stefano Cafarotti, Davide La Regina, Francesco Mongelli, Andrea Saporito

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Background and objectives
In this systematic review, we carried out an assessment of perioperative costs of local or regional anesthesia versus general anesthesia in the ambulatory setting.

A systematic literature search was conducted to find relevant data on costs and cost-effectiveness analyses of anesthesia regimens in outpatients, regardless of the medical procedure they underwent. The hypothesis was that local or regional anesthesia has a lower economic impact on hospital costs in the outpatient setting. The primary outcome was the average total cost of anesthesia calculated on perioperative costs (drugs, staff, resources used).

One-thousand-six-hundred-ninety-eight records were retrieved, and 28 articles including 27,581 patients were selected after reviewing the articles. Data on the average total costs of anesthesia and other secondary outcomes (anesthesia time, recovery time, time to home readiness, hospital stay time, complications) were retrieved. Taken together, these findings indicated that local or regional anesthesia is associated with lower average total hospital costs than general anesthesia when performed in the ambulatory setting. Reductions in operating room time and postanesthesia recovery time and a lower hospital stay time may account for this result.

Despite the limitations of this systematic review, mainly the heterogeneity of the studies and the lack of cost-effectiveness analysis, the economic impact of the anesthesia regimes on healthcare costs appears to be relevant and should be further evaluated.


Anesthesia;  Outpatients;  Costs and Cost Analysis;  Economics



Nesta revisão sistemática, realizamos uma avaliação dos custos perioperatórios de anestesia local ou regional versus anestesia geral em ambiente ambulatorial.


Uma busca sistemática da literatura foi realizada para encontrar dados relevantes sobre custos e análises de custo-efetividade de regimes de anestesia em pacientes ambulatoriais, independentemente do procedimento médico a que foram submetidos. A hipótese era de que a anestesia local ou regional tem menor impacto econômico nos custos hospitalares em regime ambulatorial. O desfecho primário foi o custo total médio da anestesia calculado sobre os custos perioperatórios (medicamentos, equipe, recursos utilizados).


Foram recuperados 1.698 registros e 28 artigos incluindo 27.581 pacientes, selecionados após a revisão dos artigos. Os dados sobre os custos totais médios da anestesia e outros resultados secundários (tempo de anestesia, tempo de recuperação, tempo de preparação para casa, tempo de internação, complicações) foram recuperados. Tomados em conjunto, esses achados indicaram que a anestesia local ou regional está associada a custos hospitalares totais médios mais baixos do que a anestesia geral quando realizada em ambiente ambulatorial. As reduções no tempo de sala de cirurgia e no tempo de recuperação pós-anestésica e um menor tempo de internação podem ser responsáveis por esse resultado.


Apesar das limitações desta revisão sistemática, principalmente a heterogeneidade dos estudos e a falta de análise de custo-efetividade, o impacto econômico dos regimes anestésicos nos custos de saúde parece ser relevante e deve ser melhor avaliado.


Anestesia; Pacientes ambulatoriais; Custos e Análise de Custos; Economia


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