title: Economics and practice management issues associated with acute pain management.
abstract: The use of regional anesthesia (RA) improves cost benefit (hospital-centered) and cost utility (patient-centered) over general anesthesia with volatile agents (GAVA), based upon research in outpatient populations. To make the cost savings a reality, the authors recommend: (1) avoidance of GAVA or at least volatile agents, (2) adopting published postanesthesia care unit (PACU)-bypass criteria conducive to RA, (3) maximizing PACU-bypass rates, and (4) utilizing a block induction area. Inpatient-based acute pain services are not uniform, which makes cost analyses and comparison between practices unreliable. Additional review and commentary address surgical site infections, cancer recurrence, blood transfusions, and chronic postsurgical pain.
authors.affiliation: Department of Anesthesiology, University of Pittsburgh Medical Center, Liliane S. Kaufmann Building, 3471 Fifth Avenue Suite 910, Pittsburgh, PA 15213, USA. phillipsd4@upmc.edu
authors.forename: Dennis P
authors.initials: DP
authors.lastname: Phillips
authors.forename: Tara L
authors.initials: TL
authors.lastname: Knizner
authors.forename: Brian A
authors.initials: BA
authors.lastname: Williams
mesh_terms: D000208:Acute Disease; D000765:Anesthesia, Conduction / Q000191:economics*; D003362:Cost-Benefit Analysis; D006801:Humans; D007902:Length of Stay; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D059408:Pain Management; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control; D018084:Ultrasonography, Interventional