Cost–benefit evaluation of liposomal bupivacaine in the management of patients undergoing total knee arthroplasty
| Autor: | Jinma Ren, Edward C. Rainville, Carl V. Asche, Carmen S. Kirkness, Minchul Kim |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Cost-Benefit Analysis medicine.medical_treatment Total knee arthroplasty 03 medical and health sciences 0302 clinical medicine Femoral nerve medicine Humans Pain Management 030212 general & internal medicine Anesthetics Local Arthroplasty Replacement Knee Aged Retrospective Studies Pharmacology Bupivacaine Pain Postoperative 030222 orthopedics business.industry Health Policy Retrospective cohort study Hospital cost Middle Aged Liposomal Bupivacaine Arthroplasty Surgery Anesthesia Liposomes Female Cost benefit business medicine.drug |
| Zdroj: | American Journal of Health-System Pharmacy. 73:e247-e254 |
| ISSN: | 1535-2900 1079-2082 |
| Popis: | Purpose Results of a cost–benefit analysis of intraoperative use of liposomal bupivacaine for postsurgical pain management in patients undergoing total knee arthroplasty (TKA) are presented. Methods In a retrospective single-site study, clinical and cost outcomes were compared in a group of 134 consecutive patients who received liposomal bupivacaine (by local infiltration) during TKA and a propensity score–matched historical cohort of 134 patients undergoing TKA who received usual care (continuous femoral nerve blockade with conventional bupivacaine delivered via elastomeric pump). Results Postsurgical pain scores and opioid use were similar in the two study groups; the mean total amount of nonsteroidal antiinflammatory drugs administered was lower in the liposomal bupivacaine group. Patients who received liposomal bupivacaine typically ambulated earlier than those who received usual care (22% and 3%, respectively, walked on the day of surgery; p < 0.05) and were more likely to be discharged within two days (50% versus 19%, p < 0.001); on average, liposomal bupivacaine– treated patients walked farther on the day of surgery (6.0 m versus 3.1 m, p < 0.001) and the day after surgery (63.7 m versus 25.5 m, p < 0.001) and had a shorter length of stay (LOS) (3.1 days versus 3.6 days, p < 0.03). The mean adjusted total direct hospital cost per patient was significantly lower with liposomal bupivacaine use versus usual care ($8758 versus $9213, p = 0.033). Conclusion In patients undergoing TKA, intraoperative administration of liposomal bupivacaine for management of postsurgical pain was found to offer advantages over usual care, including decreased time to ambulation and reduced hospital LOS. |
| Databáze: | OpenAIRE |
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