title: The effect of anesthesia type on nonsurgical operating room time.
abstract: OBJECTIVE
  To determine the effect of local-only anesthesia on nonsurgical time compared with monitored anesthesia care (MAC)/local and general anesthesia. Our hypothesis was that local-only anesthesia cases would have lower nonsurgical times compared with MAC/local and general anesthesia.
  
  
  METHODS
  We retrospectively reviewed the surgical records of 1,179 patients undergoing elective hand surgery. For each case, we recorded the type of anesthesia used (general, MAC/local, or local-only anesthesia) and in-room presurgical time, in-room postsurgical time, and, if relevant, room turnover time. We did not record room turnover times for the first case of the day or for cases after procedures that did not meet inclusion criteria. We also recorded the presence of any anesthesia providers (anesthesiologist vs anesthesia-assistant [certified registered nurse anesthetist]).
  
  
  RESULTS
  A total of 566 cases performed on 501 patients met inclusion criteria. Room turnover times were not calculated for 304 cases. The choice of anesthesia had a significant effect on nonsurgical operating room time. Local anesthesia cases had significantly less nonsurgical time compared with general anesthesia and MAC/local. Cases performed under MAC/local anesthesia also had significantly reduced nonsurgical time compared with general anesthesia. The presence of a certified anesthesia assistant had no effect on any time metrics recorded.
  
  
  CONCLUSIONS
  Choice of local anesthesia, when appropriate, may facilitate rapid operating room turnover and improve overall facility efficiency with lower costs.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedic Surgery, St. Luke's University Hospital, Bethlehem, PA.
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Caggiano
authors.affiliation: Department of Orthopaedic Surgery, St. Luke's University Hospital, Bethlehem, PA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Avery
authors.affiliation: Department of Orthopaedic Surgery, St. Luke's University Hospital, Bethlehem, PA. Electronic address: Kristofer.Matullo@sluhn.org.
authors.forename: Kristofer S
authors.initials: KS
authors.lastname: Matullo
mesh_terms: D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General; D000772:Anesthesia, Local; D017598:Efficiency, Organizational; D006225:Hand / Q000601:surgery; D006801:Humans; D009873:Operating Rooms / Q000458:organization & administration*; D010414:Pennsylvania; D012189:Retrospective Studies; D013997:Time Factors
keywords: Operating room efficiency; local anesthesia; nonsurgical time