Local Versus General Anesthesia in Pediatric Otoplasty: A Cost and Efficiency Analysis.

Objective: Quantify the cost benefits of otoplasty under local as opposed to general anaesthesia.

Design: A cost analysis of all components of otoplasty surgery under local anaesthesia (LA) in a minor operating room (OR) and general anaesthesia in a main OR was performed.

Setting: Our institution, compared to provincial/federal data, with costs converted into 2022 Canadian dollars.

Patients, participants: Patients undergoing otoplasty under LA in the last year.

Interventions: An efficiency analysis was performed by means of an opportunity cost, and the cost of failure was added to the overall LA costs.

Main outcome measure: Expenses for infrastructure, surgical and anaesthetic material, salaries, and personnel costs were derived from the literature, our hospital OR catalog and federal/provincial salary data, respectively. The cost of failure to tolerate local anaesthesia for such cases was also tabulated.

Results: The true cost of LA otoplasty was computed as the absolute cost ($611.73) added to the cost of failure ($10.80), resulting in a total of $622.53/procedure. The true cost of GA otoplasty was calculated as the absolute cost ($2033.05) added to the opportunity cost ($1108.94), representing 3141.99$/procedure. The total savings when performing LA otoplasty to GA otoplasty are thus 2519.44$/case, with 1 GA otoplasty costing 5.05 LA otoplasties.

Conclusion: Otoplasty under local anaesthesia offers significant cost savings when compared with the same procedure under general anaesthesia. Economic considerations must be given particular attention given the elective nature of this procedure, which is often publicly funded.