A deciion analyi of anetheia management for cataract urgery

PURPOE: To compare the trade-off in cot and preference of variou anetheia management trategie for cataract urgery. METHOD: ix trategie, differing in edation, local anethetic, and monitoring approach, were choen for comparion. For each trategy, potential complication, and converion to different anetheia approache were modeled. A panel of phyician and anethetit, well vered in the literature and practice of the anetheia management of cataract urgery, aigned preference value to the trategie and potential outcome (0 to 1 cale). Probability etimate were obtained from a tudy of 19,557 cataract urgerie and from the panel. Cot etimate were derived from everal ource. The model wa analyzed to determine the trategie aociated with the highet expected preference and lowet expected cot. REULT: The trategy aociated with the highet net preference wa intravenou edation with block anetheia and an anetheiologit preent throughout the cae. The expected net preference for thi trategy wa 19% greater than the net preference for the next mot preferred trategy, oral edation with block anetheia and an anetheiologit on call (0.88 veru 0.74), but the expected anetheia cot per cae were much greater ($324 veru $42). Reult were enitive to plauible variation in the preference value aigned to the ix initial management trategie and to the cot of topical veru block anetheia. CONCLUION: Thi analyi emphaize that cot and preference are important conideration when chooing an anetheia management trategy for cataract urgery. For ome urgerie, ubtantial cot aving may be available for a mall change in preference.