title: [Spinal anesthesia versus general anesthesia in the surgical treatment of inguinal hernia. Cost-effectiveness analysis].
abstract: OBJECTIVE
  To compare the costs related to the clinical effectiveness of general anesthesia versus spinal anesthesia in inguinal hernioplasty ambulatory surgery.
  
  
  METHODS
  An observational, retrospective cohort study measurement and analysis of cost-effectiveness, in the ambulatory surgery unit of a general hospital. All patients over 18 years of age diagnosed with primary inguinal hernia and scheduled for unilateral hernioplasty between January 2010 and December 2011 were included. Duration of anesthetic induction, length of stay in both the operating room, and in the post-anesthesia care unit, the anesthetic effectiveness (the incidence of adverse effects and the patient's comfort level), and variable economic costs associated with the use of drugs, as well as the use of human resources, were compared.
  
  
  RESULTS
  The final analysis included 218 patients, 87.2% male, with a mean age of 53 years (range: 18-85 years). Of these, 139 (63.76%) received subarachnoid anesthesia and 79,(36.2%) general anesthesia. The length of time a patient remained in the post-anesthesia care unit was 337.6±160.2min in the subarachnoid anesthesia group, and 210.0±97.5min for the general anesthesia group (P<.001). Costs of drugs for general anesthesia were higher than that for subarachnoid anesthesia (86.2±8.3 vs. 18.7±7.2). The total cost difference between the 2 techniques was €115.8 more for subarachnoid anesthesia (P<.001).
  
  
  CONCLUSIONS
  Both techniques showed similar effectiveness. The overall costs for subarachnoid anesthesia were greater than for the general. The cost-effectiveness of general anesthesia is better for outpatient inguinal hernia repair surgery.
authors: Departamento de Investigación, Docencia y Formación, Complejo Hospitalario Mancha Centro, Alcázar de San Juan, Ciudad Real, España. Electronic address: marujaf@hotmail.com.
authors: M
authors: M
authors: Fernández-Ordóñez
authors: Departamento de Investigación, Docencia y Formación, Complejo Hospitalario Mancha Centro, Alcázar de San Juan, Ciudad Real, España.
authors: J M
authors: JM
authors: Tenías
authors: Departamento de Cirugía, Complejo Hospitalario Mancha Centro, Alcázar de San Juan, Ciudad Real, España.
authors: J
authors: J
authors: Picazo-Yeste
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000191:economics; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000191:economics*; D000775:Anesthesia, Spinal / Q000191:economics*; D018681:Anesthetics, General / Q000009:adverse effects / Q000191:economics; D000779:Anesthetics, Local / Q000009:adverse effects / Q000191:economics; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000191:economics*; D006769:Hospitals, General / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010564:Personnel, Hospital / Q000191:economics; D011997:Recovery Room; D012189:Retrospective Studies; D013030:Spain; D055815:Young Adult
chemical_list: D018681:Anesthetics, General; D000779:Anesthetics, Local
keywords: Ambulatory surgery; Anestesia general; Anestesia subaracnoidea; Análisis de costes; Cirugía ambulatoria; Cost analysis; Farmacoeconomía; General anesthesia; Hernia inguinal; Inguinal hernia; Pharmaco-economics; Spinal anesthesia