Cochlear implantation without general anaesthesia: a resource-efficient surgical pathway.

OBJECTIVES

This study aimed to compare the environmental and financial impact of cochlear implantation performed with and without general anaesthesia.

METHODS

Two cochlear implant procedures performed on the same day by the same surgical and anaesthetic teams were prospectively evaluated: one under total intravenous anaesthesia with bispectral index monitoring, and one under local anaesthesia with propofol sedation. Anaesthetic drugs, consumables, equipment, electricity use and procedural duration were recorded. Financial costs were estimated using procurement data and national formularies. Carbon dioxide equivalent emissions were calculated using published conversion factors.

RESULTS

Local anaesthesia was associated with lower cost (£59 vs. £179) and lower carbon footprint (2.85 vs. 5.28 kg carbon dioxide equivalent). Procedural duration was similar between pathways (71 vs. 74 minutes).

CONCLUSION

Cochlear implantation without general anaesthesia may reduce environmental and financial cost without prolonging procedural duration. Anaesthetic pathway selection represents a modifiable determinant of resource use in otological practice.