title: Hospital Charges and Practice Patterns for General and Regional Anesthesia in Arthroscopic Anterior Cruciate Ligament Repair.
abstract: BACKGROUND
  Anesthetic use for arthroscopic anterior cruciate ligament (ACL) reconstruction may display variability in hospital charges and utilization in the United States.
  
  
  OBJECTIVE
  To evaluate practice patterns and hospital charges for anesthesia in arthroscopic ACL reconstruction.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  The PearlDiver Patient Records Database, a national database of insurance billing records, was searched using the current procedural terminology (CPT) codes for arthroscopic ACL reconstruction in combination with different types of anesthesia. The search included the years between 2004 and 2009. Age, sex, number of procedures performed, geographic region, and hospital charges for each type of anesthesia were recorded and compared. Anesthetic types were categorized as general anesthesia (GA) only, GA with concomitant single femoral injection, GA with concomitant other regional anesthesia (RA), single femoral injection only, or other RA only.
  
  
  RESULTS
  Between 2004 and 2009, a total of 53,968 arthroscopic reconstructive procedures were identified. The mean per patient hospital charge for GA alone, GA in combination with single femoral injection, GA in combination with other RA, single femoral injection alone, and RA alone was $1065 (63% of cases), $1614 (29%), $1849 (4%), $630 (3%), and $612 (1%), respectively. The use of GA in combination with RA or single femoral nerve injection significantly increased during this time period (P = .004 and P < .001, respectively).
  
  
  CONCLUSIONS
  The mean per patient hospital charges for arthroscopic ACL reconstruction varied with the mode of anesthesia utilized, where regional anesthetic techniques alone were least expensive. RA alone was utilized infrequently, and there was a significant increase in the rate of utilization of GA in combination with any form of RA.
  
  
  CONCLUSIONS
  This study provides information on current trends and hospital charges for anesthesia in arthroscopic ACL reconstruction.
authors.affiliation: Department of Orthopaedic Surgery, Keck Medical Center of USC, Los Angeles, California, USA.
authors.forename: Brock D
authors.initials: BD
authors.lastname: Foster
authors.affiliation: Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Rodney
authors.initials: R
authors.lastname: Terrell
authors.affiliation: Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Montgomery
authors.affiliation: Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Frank A
authors.initials: FA
authors.lastname: Petrigliano
authors.affiliation: Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: McAllister
keywords: ACL; anesthesia; cost analysis; demographics