Local infiltration analgesia versus peripheral nerve block anaesthesia in total knee arthroplasty: a pharmaco-economic comparison.

Autor: Borck M; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.; Berlin Institute of Health , Charitéplatz 1, 10117, Berlin, Germany.; Department of Anaesthesiology and Intensive Care, Campus Charité Mitte and Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany., Wandrey JD; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.; Berlin Institute of Health , Charitéplatz 1, 10117, Berlin, Germany.; Department of Anaesthesiology and Intensive Care, Campus Charité Mitte and Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany., Höft M; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.; Berlin Institute of Health , Charitéplatz 1, 10117, Berlin, Germany.; Department of Anaesthesiology and Intensive Care, Campus Charité Mitte and Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany., Kastelik J; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.; Berlin Institute of Health , Charitéplatz 1, 10117, Berlin, Germany.; Department of Anaesthesiology and Intensive Care, Campus Charité Mitte and Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany., Perka C; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.; Berlin Institute of Health , Charitéplatz 1, 10117, Berlin, Germany.; Centre for Musculoskeletal Surgery, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany., Tafelski S; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.; Berlin Institute of Health , Charitéplatz 1, 10117, Berlin, Germany.; Department of Anaesthesiology and Intensive Care, Campus Charité Mitte and Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany., Treskatsch S; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany. sascha.treskatsch@charite.de.; Berlin Institute of Health , Charitéplatz 1, 10117, Berlin, Germany. sascha.treskatsch@charite.de.; Department of Anaesthesiology and Intensive Care, Charité Campus Benjamin Franklin (CBF), Hindenburgdamm 30, 12203, Berlin, Germany. sascha.treskatsch@charite.de.
Jazyk: angličtina
Zdroj: BMC anesthesiology [BMC Anesthesiol] 2022 Mar 25; Vol. 22 (1), pp. 80. Date of Electronic Publication: 2022 Mar 25.
DOI: 10.1186/s12871-022-01620-w
Abstrakt: Background: A superior analgesic method in perioperative pain-management of patients receiving total knee arthroplasty is the subject of controversial debate. Although higher cost-efficiency is claimed for the local infiltration analgesia (LIA), there is a lack of data on its costs compared to peripheral nerve block anaesthesia (PNBA). The goal of this study was to investigate the differences in immediate perioperative costs between the LIA and PNBA in treatment of patients receiving total knee arthroplasty.
Methods: The comparison was conducted based on a randomized controlled clinical trial examining 40 patients with elective, primary total knee arthroplasty (TKA, 20 patients with LIA and 20 patients with PNBA). The analysis included surgical case costs, anaesthesiological case costs, material, costs of postoperative opioid requirements and catheter review visits for patients receiving PNBA.
Results: The overall mean costs for the LIA-group were 4328.72€ and 4368.12€ for the PNBA (p = 0.851). While there was no statistically significant difference in surgical case costs, the anaesthesiological costs were lower with the LIA procedure (1370.26€ vs. 1542.45€, p = 0.048). Material costs in the LIA group were 4.18€/patient and 94.64€/patient with the PNBA. Costs for postoperative opioid requirements showed no statistically significant difference between the two procedures.
Conclusions: There is no relevant difference in immediate perioperative costs between LIA and PNBA. Shorter induction times lead to lower anaesthesiological case costs with the LIA. Overall economic aspects seem to play a less important role for determining an adequate procedure for perioperative pain management.
Trial Registration: The study was approved by the ethics-review-board of Charité Hospital Berlin (Ethikausschuss 4, Charité - Universitätsmedizin Berlin, on 16th February 2017) and registered with data safety authorities. Study patients provided written informed consent to participate in the trial. Study registry: ClinicalTrials.gov, NCT03114306 .
(© 2022. The Author(s).)
Databáze: MEDLINE
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