Background

There is a paucity of data providing direct comparison of outcomes, complications, and costs between general and local anesthesia in cutaneous surgery.

Objective

Analyze the literature from dermatologic and other specialties to compare outcomes, risks, and costs of general and local anesthesia.

Methods

A retrospective analysis of case comparison studies from other specialties comparing outcomes, risks, and/or costs in local versus general anesthesia was performed. A review of the literature from dermatology and other specialties was included.

Results

A total of 51 studies were selected; 41 of them directly examined outcomes in procedures performed under local and general anesthesia, and none found a significant difference in outcomes. A total of 41 studies measured adverse effects. Of these, 15 studies (36.6%) report significantly better outcomes between the 2 techniques. Only 2 studies (4.9%) report significantly improved outcomes with use of general anesthesia; 15 of 36 studies (41.7%) report fewer adverse events in local anesthesia. Of the 13 studies that examined costs, all (100%) found significantly decreased costs with use of local anesthesia.

Limitations

These data cannot be seamlessly applied to all cases of cutaneous surgery.

Conclusion

Local anesthesia techniques provide outcomes equal to or better than general anesthesia and with significantly lower costs.

中文翻译：

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评估局部麻醉与全身麻醉的结果，风险和费用：一项涉及皮肤手术的综述

背景

缺乏数据可以直接比较皮肤手术中全身麻醉和局部麻醉的结果，并发症和费用。

客观的

分析皮肤病学和其他专业的文献，以比较全麻和局部麻醉的结果，风险和费用。

方法

对来自其他专业的病例比较研究进行回顾性分析，比较局部麻醉与全身麻醉的结局，风险和/或费用。包括对皮肤病学和其他专业文献的综述。

结果

总共选择了51项研究；他们中的41名直接检查了在局麻和全身麻醉下进行的手术的结局，没有人发现结局有显着差异。共有41项研究测量了不良反应。其中，有15项研究（36.6％）报告说这两种技术之间的结局明显好转。只有2项研究（4.9％）报告说，使用全身麻醉可显着改善预后。36项研究中的15项（41.7％）报告说局部麻醉的不良事件更少。在13项检查成本的研究中，所有（100％）发现使用局部麻醉可以显着降低成本。

局限性

这些数据不能无缝地应用于所有皮肤手术病例。

结论

局部麻醉技术可提供与全身麻醉相同或更好的治疗效果，且成本明显降低。