Comparaison des coûts entre la rachianesthésie et l’anesthésie générale pour l’arthroplastie de la hanche et du genou: une étude de coût incrémentielle

Translated title of the contribution: Cost comparison between spinal versus general anesthesia for hip and knee arthroplasty: an incremental cost study

Jonathan G. Bailey, Ashley Miller, Glen Richardson, Tyler Hogg, Vishal Uppal

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Purpose: Wait list times for total joint arthroplasties have been growing, particularly in the aftermath of the COVID-19 pandemic. Increasing operating room (OR) efficiency by reducing OR time and associated costs while maintaining quality allows the greatest number of patients to receive care. Methods: We used propensity score matching to compare parallel processing with spinal anesthesia in a block room vs general anesthesia in a retrospective cohort of adult patients undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). We compared perioperative costs, hospital costs, OR time intervals, and complications between the groups with nonparametric tests using an intention-to-treat approach. Results: After matching, we included 636 patients (315 TKA; 321 THA). Median [interquartile range (IQR)] perioperative costs were CAD 7,417 [6,521–8,109], and hospital costs were CAD 10,293 [9,344–11,304]. Perioperative costs were not significantly different between groups (pseudo-median difference [MD], CAD −47 (95% confidence interval [CI], −214 to −130; P = 0.60); nor were total hospital costs (MD, CAD −78; 95% CI, −340 to 178; P = 0.57). Anesthesia-controlled time and total intraoperative time were significantly shorter for spinal anesthesia (MD, 14.6 min; 95% CI, 13.4 to 15.9; P < 0.001; MD, 15.9; 95% CI, 11.0 to 20.9; P < 0.001, respectively). There were no significant differences in complications. Conclusion: Spinal anesthesia in the context of a dedicated block room reduced both anesthesia-controlled time and total OR time. This did not translate into a reduction in incremental cost in the spinal anesthesia group.

Translated title of the contributionCost comparison between spinal versus general anesthesia for hip and knee arthroplasty: an incremental cost study
Original languageFrench
JournalCanadian Journal of Anaesthesia
DOIs
Publication statusAccepted/In press - 2022

Bibliographical note

Funding Information:
The authors thank the Dalhousie University Department of Anesthesia, Pain & Perioperative Medicine and the Nova Scotia Health Authority Research Fund for their support of this study (Halifax, NS, Canada).

Publisher Copyright:
© 2022, Canadian Anesthesiologists' Society.

ASJC Scopus Subject Areas

  • Anesthesiology and Pain Medicine

PubMed: MeSH publication types

  • Journal Article

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