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Anesth Analg 2006;102:524-529
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000194292.81614.c6

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH

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

Christopher Gonano, MD, MBA, Ursula Leitgeb, MD, Christian Sitzwohl, MD, Gerald Ihra, MD, Christian Weinstabl, MD, and Stephan C. Kettner, MD

Department of Anesthesiology and General Intensive Care, Medical University of Vienna, Austria

Address correspondence and reprint requests to Christopher Gonano, MD, MBA, Department of Anesthesiology and General Intensive Care, Medical University of Vienna 18-20 Waehringer Guertel A – 1090 Vienna Austria. Address e-mail to christopher.gonano{at}meduniwien.ac.at.

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.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.