Arrhythmias & electrophysiology
Tumescent local anesthesia versus general anesthesia for subcutaneous implantable cardioverter-defibrillator implantation: A cost-effectiveness analysis
Authors' conclusion
TLA is a more cost-effective alternative to GA for S-ICD implantation, with both direct and indirect cost reductions.
Study context
- Population
- Patients undergoing subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation, 2019–2022successful S-ICD implantation
- Participants
- 70 patients
- Exposure
- Tumescent local anesthesia vs general anesthesia for S-ICD implantation
- Outcome
- Cost-effectiveness (cost analysis; effectiveness: 0–10 Numeric Pain Rating Scale), by incremental cost-effectiveness ratios
- Follow-up
- Pain at 1, 12 and 24 hours post-implantation
Methodological detailsnonrandomized
- Nonrandomized
Main finding
As reported in the abstract
Total electrophysiology laboratory cost
P < 0.001
- Net saving with tumescent local anesthesia (TLA) vs general anesthesia (GA) per S-ICD implantation
- $20,821
Observational data: associations, not effects.
Further findings
| Outcome | TLA | GA | P value |
|---|---|---|---|
| Post-procedural pain score (0–10 NPRS) · 1, 12 and 24 hoursRepeated measures ANOVA · median ± IQR | P = 0.009 | ||
| 1 hour | 0 ± 3 | 0 ± 5 | P = 0.058 |
| 12 hours | 3 ± 4 | 6 ± 8 | P = 0.030 |
| 24 hours | 0 ± 4 | 2 ± 6 | P = 0.040 |
Original publication
Tumescent local anesthesia versus general anesthesia for subcutaneous implantable cardioverter-defibrillator implantation: A cost-effectiveness analysis. Heart Rhythm. Published 21 December 2022. doi:10.
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