Spinal Versus General Anesthesia for Orthopedic Surgery: Anesthesia Drug and Supply Costs

Abstract

Total hip or knee replacement surgeries are common orthopedic interventions that can be performed with spinal anesthesia (SA) or general anesthesia (GA). No study has investigated the economic aspects associated with the two anesthetic techniques for this common surgery. We randomized 40 patients to receive either SA or GA and analyzed the drug and supply costs for anesthesia und recovery. Anesthesia-related times, hemodynamic variables, and pain scores were also recorded. Total costs per case without personnel costs were almost half in the SA group compared with the GA group; this was a result of less cost for anesthesia (P < 0.01) and for recovery (P < 0.05). This finding was supported by a sensitivity analysis. There were no relevant differences regarding anesthesia-related times. Patients in the GA group were admitted to the postanesthesia care unit with a higher pain score and needed more analgesics than patients in the SA group (both P < 0.01). We conclude that SA is a more cost-effective alternative to GA in patients undergoing hip or knee replacement, as it is associated with lower fixed and variable costs. Moreover, SA seems to be more effective, as patients in the SA group showed lower postoperative pain scores during their stay in the postanesthesia care unit.

Perioperative outcomes and type of anesthesia in hip surgical patients: An evidence based review

“…In contrast to perceived delays total hip replacement surgery operating times were significantly reduced in patients receiving regional anesthesia [12] . Some studies argue that spinal anesthesia is associated with a benefit reflected in significant cost-reduction both in anesthesia times and recovery compared to general anesthesia in total hip or knee replacement operations [57] . When studying population data, results suggest a lower incidence of increased cost in neuraxial patients combined with a lower risk for prolonged length of stay [6] .…”

Cost estimates of spinal versus general anaesthesia for fractured neck of femur surgery

“…If both methods are equally effective and yield similar outcomes, then the least expensive is rationally preferable. For knee and hip arthroplasty, one previous study reported that the total cost per case (without personnel costs) was twice as much for general compared with spinal anaesthesia [15]. The main aim of this study was to assess if this was also the case when personnel costs were included for hip fracture repair.…”

Neuraxial anesthesia improves long-term survival after total joint replacement: a retrospective nationwide population-based study in Taiwan

“…After conducting a small randomized controlled trial to investigate the costs associated with GA and spinal anesthesia for elective hip or knee replacement, Gonano et al found that spinal anesthesia is more cost-effective than GA as it is associated with lower fixed and variable costs. 28 We investigated the total hospital treatment costs for primary total hip or knee replacements performed in Taiwan from 1997 to 2010. As there was a significant difference in the costs of different anesthetic techniques we investigated the hospital treatment costs with and without anesthesia-related expenses.…”