title: Spinal versus general anesthesia for orthopedic surgery: anesthesia drug and supply costs.
abstract: Total hip or knee replacement surgeries are common orthopedic interventions that can be performed with spinal anesthesia (SA) or general anesthesia (GA). No study has investigated the economic aspects associated with the two anesthetic techniques for this common surgery. We randomized 40 patients to receive either SA or GA and analyzed the drug and supply costs for anesthesia und recovery. Anesthesia-related times, hemodynamic variables, and pain scores were also recorded. Total costs per case without personnel costs were almost half in the SA group compared with the GA group; this was a result of less cost for anesthesia (P < 0.01) and for recovery (P < 0.05). This finding was supported by a sensitivity analysis. There were no relevant differences regarding anesthesia-related times. Patients in the GA group were admitted to the postanesthesia care unit with a higher pain score and needed more analgesics than patients in the SA group (both P < 0.01). We conclude that SA is a more cost-effective alternative to GA in patients undergoing hip or knee replacement, as it is associated with lower fixed and variable costs. Moreover, SA seems to be more effective, as patients in the SA group showed lower postoperative pain scores during their stay in the postanesthesia care unit.
authors.affiliation: Department of Anesthesiology and General Intensive Care, Medical University of Vienna, Austria. christopher.gonano@meduniwien.ac.at
authors.forename: Christopher
authors.initials: C
authors.lastname: Gonano
authors.forename: Ursula
authors.initials: U
authors.lastname: Leitgeb
authors.forename: Christian
authors.initials: C
authors.lastname: Sitzwohl
authors.forename: Gerald
authors.initials: G
authors.lastname: Ihra
authors.forename: Christian
authors.initials: C
authors.lastname: Weinstabl
authors.forename: Stephan C
authors.initials: SC
authors.lastname: Kettner
mesh_terms: D000700:Analgesics / Q000191:economics / Q000627:therapeutic use; D000768:Anesthesia, General / Q000191:economics*; D000775:Anesthesia, Spinal / Q000191:economics*; D000777:Anesthetics / Q000191:economics; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005062:European Union; D017721:Hospital Costs; D006801:Humans; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics; D020250:Postoperative Nausea and Vomiting / Q000191:economics / Q000628:therapy
chemical_list: D000700:Analgesics; D000777:Anesthetics