Systemic outcomes of anesthesia method in anti-vascular endothelial growth factor therapy for retinopathy of prematurity: General vs topical

Table 1 Demographic data of study population, n (%)

	Total (n = 36)	GA (n = 18)	TA (n = 18)	P value
Females	17 (47.2)	12 (66.7)	5 (27.8)	0.044
Males	19 (52.8)	6 (33.3)	13 (72.2)	0.044
ANH	12 (33.3)	9 (50)	3 (16.7)	0.151
SQUH	8 (22.2)	5 (27.8)	3 (16.7)	0.151
Others	16 (44.4)	4 (22.2)	12 (66.7)	0.151
Gestational age (weeks), mean (SD)	Not applicable	27.18 (2.4)	25.13 (1.6)	0.020
Birth weight (kg), mean (SD)	Not applicable	0.99 (0.25)	0.71 (0.14)	0.004

GA: General anesthesia; TA: Topical anesthesia; ANH: Al-Nahdha hospital; SQUH: Sultan Qaboos university hospital.

Table 2 Primary outcome and clinical parameters 48 hours post-procedure, n (%)

	GA	TA	P value
Episodes of apnea	3 (16.6)	1(5.6)	0.601
Need for oxygen 48 hours post-procedure	5 (27.8)	1 (5.6)	0.177
Need for respiratory support 48 hours post procedure	5 (27.8)	0 (0.0)	0.045
RR (breath/minute), mean (SD)	42.5 (10.8)	47 (6.7)	0.187
HR (beat/minute), mean (SD)	144.8 (9.0)	150 (10.1)	0.771
Syst. p(B) (mmHg), mean (SD)	80.3 (7.5)	77.9 (13.6)	0.046
Dia. P(B) (mmHg), mean (SD)	41.3 (5.9)	50 (17.3)	0.001
Oxygen saturation (%), mean (SD)	98.4 (2.1)	96.8 (2.5)	0.443

HR: Heart rate; GA: General anesthesia; RR: Respiratory rate; TA: Topical anesthesia; p(B): Blood pressure.

Table 3 Risk ratio between two groups

	Topical anesthesia	General anesthesia	Total
Adverse outcome (+)	1	5	6
Adverse outcome (-)	17	13	30
Total	18	18	36
Risk in TA (R1)	1/18 = 0.05
Risk in GA (R0)	5/18 = 0.28
Risk difference	0.05-0.28 = -0.23
Risk ratio	0.05/0.28 = 0.18

GA: General anesthesia; TA: Topical anesthesia.

Table 4 Summary of list of items considered in the cost calculation of each type of procedures

	General anesthesia	Topical anesthesia
Pre-op	Medication (Lucentis)	Medication (Lucentis)
	Anesthesia consultation +/- any subspeciality asked by anesthesia
Intra-op	Anesthesia doctor + anesthesia nurse + medications + instruments	NICU staff
	OR nurse/ophthalmic	NICU nurse
	Surgeon	Surgeon
	Shifting patient from the ward to OR
	OR time 30-60 minutes
Post-op	Post-op recovery	NICU nurse observation
	Shifting from OR to ward

NICU: Neonatal intensive care unit; OR: Operation theater.

Table 5 Summary of the cost of each stage of the procedure in the general anesthesia group

	GA	Cost
Pre-op	Anesthesia consultation +/- any subspeciality asked by anesthesia	130 $
Intra-op	Anesthesia doctor + medications + instruments	390 $
	OR time 30-60 minutes	2150 $
Post-op	Post-op recovery	52 $
Total	2722 $

GA: General anesthesia.