Pediatric anesthesia & critical care
Cost-effectiveness analysis of anaesthesia regimens for paediatric strabismus surgery based on multicentre retrospective cohort data from Japan
Authors' conclusion
TIVA with DEX alone is the most cost-effective regimen for preventing POV in paediatric strabismus surgery in the current Japanese public healthcare system.
Study context
- Population
- Children (aged 3–15 years) undergoing strabismus surgery at three institutions in Japan (February 2016-November 2023)
- Participants
- 2,772 children
- Exposure
- Total intravenous anaesthesia (TIVA) with sub-Tenon block, dexamethasone (DEX) and ondansetron (OND) vs TIVA with sub-Tenon block and DEX
- Outcome
- Cost per averted postoperative vomiting (POV) (aPOV)
- Follow-up
- Within 24 hours post-surgery
Methodological detailsmulticentre, Japanese public healthcare payer perspective, sensitivity analyses
- Multicentre
- Japanese public healthcare payer perspective
- Sensitivity analyses
Main finding
As reported in the abstract
aPOV rate (cost per aPOV within 24 h post-surgery) · 24 hours post-surgery
- Incremental cost of adding OND
- €21.2
- ICER of adding OND (per averted POV (aPOV))
- €400.6
Observational data: associations, not effects.
Further findings
| Outcome | TIVA+DEX | TIVA+DEX+OND | TIVA only |
|---|---|---|---|
| Probability of cost-effectiveness (cost-effectiveness acceptability frontier, thresholds €0-€200 per aPOV) | 0% to 97.4% | 0% to 9.3% | 100% to 0% |
Sensitivity analysis
- OND cost was the most influential factor
Original publication
Cost-effectiveness analysis of anaesthesia regimens for paediatric strabismus surgery based on multicentre retrospective cohort data from Japan. BJA Open. Published 7 May 2025. doi:10.
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