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Pediatric Circumcision and Spinal Anesthesia: Fast, Effective, and Cheap
Adam Cole, MD, Emma Harwood, MD, Evelyn James, MPH, David Chalmers, MD, Lily C. Wang, MD, PhD.
Maine Medical Center, Portland, ME, USA.
BACKGROUND: Spinal anesthesia (SA) has proven effective and safe in pediatric urology. However, concerns about surgical delays and higher costs compared to general anesthesia (GA) may limit its adoption. This study compares costs, operative, and recovery times for pediatric circumcisions performed under SA or GA.
METHODS: We retrospectively reviewed pediatric circumcision cases at our institution (2018-2025), who were candidates for SA or GA. Those undergoing concurrent procedures were excluded. Operative and recovery times, along with costs, were compared between anesthesia types using a Mann-Whitney U test.
RESULTS: We analyzed 889 patients (482 GA, 407 SA). Total operating room (OR) time did not differ significantly (p = 0.48). SA required slightly more OR time pre-procedure (+1.46 min, p<0.0001) but reduced post-procedure time (-2.83 min, p<0.0001). Recovery time was significantly shorter with SA (-9.63 min, p<0.0001) (Table 1). While SA supply costs were 10.8% lower (p = 0.015), total costs were similar (p = 0.08).
CONCLUSIONS: SA results in faster recovery and comparable OR time without increasing costs. These findings support SA as a safe, efficient alternative to GA, enabling quicker patient recovery without added expense or OR delays.
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