Analysis of Operational Efficiency and Cost Differences between Local and General Anesthesia for Vitreoretinal Surgery.

There has been a growing trend of using local anesthesia (LA) compared to general anesthesia (GA) over the last two decades in VR surgery. We aim to answer the following question: what is the institutional benefit of LA versus GA use in operation-room time, anesthesia duration, earlier discharge from an outpatient surgery facility, and the estimated cost savings? We conducted a retrospective analysis of 1476 eyes that underwent vitreoretinal surgery over a 6-year period from a single site; 61.8% of patients received GA and 38.2% received LA for VR surgery. Anesthesia, surgical, and recovery times were significantly shorter with LA (100.49, 66.47, 66.47 mins) vs. GA (145.53, 100.14, 75.08 mins). Anesthesia, surgical, and recovery costs were significantly lower for eyes that received LA, with an estimated adjusted cost reduction of USD 1516 per surgery using LA instead of GA. Use of LA for vitreoretinal surgery is associated with better operational efficiency, earlier patient discharge, and significant cost reduction.