scholarly journals An Analysis of the Cost-Effectiveness of Spinal Versus General Anesthesia for Lumbar Spine Surgery in Various Hospital Settings

2018 ◽  
Vol 9 (4) ◽  
pp. 368-374 ◽  
Author(s):  
Matthew T. Morris ◽  
Jonathan Morris ◽  
Camari Wallace ◽  
Woojin Cho ◽  
Alok Sharan ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Lumbar Spine ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Operating Room ◽  
Spine Surgery ◽  
Private Practice ◽  
Hospital Setting ◽  
Academic Institution ◽  
Lumbar Spine Surgery

Study Design: Retrospective chart review. Objective: To determine the relative cost-effectiveness of spinal anesthesia and general anesthesia for lumbar laminectomy and microdiscectomy surgery performed in an academic versus private practice hospital setting. Methods: The authors retrospectively reviewed charts of 188 consecutive patients who underwent lumbar laminectomy or microdiscectomy by a single surgeon from 2012 to 2016 at either an academic or a private practice hospital setting. Intraoperative and postoperative outcomes were recorded and direct variable costs were calculated. Results: At the academic institution, the direct cost of a lumbar laminectomy or microdiscectomy surgery under general anesthesia was determined to be 9.93% greater than with spinal anesthesia ( P = .040). The greatest difference was seen with operating room costs, in which general anesthesia was associated with 18.74% greater costs than spinal anesthesia ( P = .016). There was no significant difference in cost at the private practice hospital setting. Conclusions: We conclude that use of spinal anesthesia for lumbar laminectomy leads to less operating room, postanesthesia care unit, and anesthesia times, lower levels of postoperative pain, and no increased rate of other complications compared with general anesthesia at an academic institution as compared to a private practice setting. Spinal anesthesia is 9.93% less expensive than general anesthesia, indicating substantial cost-saving potential. With no sacrifice of patient outcomes and the added benefit of less pain and recovery time, Spinal anesthesia represents a more cost-effective alternative to general anesthesia in lumbar spine surgery in the academic hospital setting.

scholarly journals 176 Efficiency of Spinal Anesthesia in Comparison to General Anesthesia in Lumbar Spine Surgery: A Retrospective Analysis of 544 Patients

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 245-246
Author(s):  
John Thomas Pierce ◽  
Prateek Agarwal ◽  
Paul J Marcotte ◽  
William Charles Welch
Keyword(s):  
Lumbar Spine ◽  
Blood Loss ◽  
Hospital Stay ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Spine Surgery ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Lumbar Spine Surgery ◽  
Anesthesia Time

Abstract INTRODUCTION Lumbar spine surgery can be successfully performed using various anesthetic techniques. Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia (SA) to general anesthesia (GA) in lumbar surgery. We sought to elucidate the more expedient anesthetic technique. METHODS Following IRB approval, a retrospective review of patients undergoing elective lumbar decompression surgery using GA or SA was performed. Demographic data known to influence perioperative morbidity was collected as well as safety and efficiency parameters. After controlling for patient and procedure characteristics, simple linear and multivariate regression analyses were performed to identify differences in operative blood loss, operative time, time from entering the OR until incision, time from bandage placement to exiting the OR, total anesthesia time, time in the post-anesthesia care unit (PACU), and length of hospital stay. RESULTS >544 consecutive lumbar laminectomy and discectomy surgeries were identified with 183 undergoing GA and 361 undergoing SA. The following times were all shorter for patients receiving SA than GA: operative time (97.4 vs. 151.8 min., P < 0.001), total anesthesia time (145.6 vs. 217.5 min., P < 0.001), time from entering the OR until incision (38.3 vs. 46.8 min., respectively, P < 0.001), time from bandage placement until exiting the OR (10.2 vs. 17.2 min., P < 0.001), and length of hospital stay (1.5 vs. 3.1 days, P < 0.001). The mean PACU length of stay was longer in the SA group than the GA group (178.0 vs. 116.5 min., P < 0.001). Estimated blood loss was less in the SA group than the GA group (62.1 vs. 176.3 mL, P < 0.001). CONCLUSION Spinal anesthesia may be the more expedient method of anesthesia in lumbar spinal surgery for all perioperative time points except for time in the PACU.

Spinal vs General Anesthesia in Lumbar Spine Surgery: A Multicenter Cost-Effectiveness Analysis

2017 ◽  
Vol 17 (10) ◽  
pp. S200
Author(s):  
Matthew Morris ◽  
Jonathan Morris ◽  
Woojin Cho ◽  
Manal Abouelrigal ◽  
Camari Wallace ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Lumbar Spine ◽  
General Anesthesia ◽  
Spine Surgery ◽  
Cost Effectiveness Analysis ◽  
Lumbar Spine Surgery ◽  
Effectiveness Analysis

Perioperative outcome and cost-effectiveness of spinal versus general anesthesia for lumbar spine surgery

2014 ◽  
Vol 48 (3) ◽  
pp. 167-173 ◽  
Author(s):  
Kadriye Kahveci ◽  
Cihan Doger ◽  
Dilsen Ornek ◽  
Derya Gokcinar ◽  
Semih Aydemir ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Lumbar Spine ◽  
General Anesthesia ◽  
Spine Surgery ◽  
Lumbar Spine Surgery ◽  
Perioperative Outcome

Spinal anesthesia in contemporary and complex lumbar spine surgery: experience with 343 cases

2021 ◽  
pp. 1-8
Author(s):  
Jeffrey M. Breton ◽  
Calvin G. Ludwig ◽  
Michael J. Yang ◽  
T. Jayde Nail ◽  
Ron I. Riesenburger ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spinal Anesthesia ◽  
Spine Surgery ◽  
Outcome Data ◽  
Lumbar Spine Surgery ◽  
Class Iii ◽  
Instrumented Fusion ◽  
Fusion Procedure ◽  
Physical Status Classification ◽  
Wide Range

OBJECTIVE Spinal anesthesia (SA) is an alternative to general anesthesia (GA) for lumbar spine surgery, including complex instrumented fusion, although there are relatively few outcome data available. The authors discuss their experience using SA in a modern complex lumbar spine surgery practice to describe its utility and implementation. METHODS Data from patients receiving SA for lumbar spine surgery by one surgeon from March 2017 to December 2020 were collected via a retrospective chart review. Cases were divided into nonfusion and fusion procedure categories and analyzed for demographics and baseline medical status; pre-, intra-, and postoperative events; hospital course, including Acute Pain Service (APS) consults; and follow-up visit outcome data. RESULTS A total of 345 consecutive lumbar spine procedures were found, with 343 records complete for analysis, including 181 fusion and 162 nonfusion procedures and spinal levels from T11 through S1. The fusion group was significantly older (mean age 65.9 ± 12.4 vs 59.5 ± 15.4 years, p < 0.001) and had a significantly higher proportion of patients with American Society of Anesthesiologists (ASA) Physical Status Classification class III (p = 0.009) than the nonfusion group. There were no intraoperative conversions to GA, with infrequent need for a second dose of SA preoperatively (2.9%, 10/343) and rare preoperative conversion to GA (0.6%, 2/343) across fusion and nonfusion groups. Rates of complications during hospitalization were comparable to those seen in the literature. The APS was consulted for 2.9% (10/343) of procedures. An algorithm for the integration of SA into a lumbar spine surgery practice, from surgical and anesthetic perspectives, is also offered. CONCLUSIONS SA is a viable, safe, and effective option for lumbar spine surgery across a wide range of age and health statuses, particularly in older patients and those who want to avoid GA. The authors’ protocol, based in part on the largest set of data currently available describing complex instrumented fusion surgeries of the lumbar spine completed under SA, presents guidance and best practices to integrate SA into contemporary lumbar spine practices.

Cost-Effectiveness of Psychologically Informed Physical Therapy in Patients after Lumbar Spine Surgery

2017 ◽  
Vol 17 (10) ◽  
pp. S61
Author(s):  
Kristin R. Archer ◽  
Clinton J. Devin ◽  
Silky Chotai ◽  
Stephen Wegener ◽  
Susan Vanston ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Lumbar Spine ◽  
Physical Therapy ◽  
Spine Surgery ◽  
Lumbar Spine Surgery

scholarly journals Spinal anesthesia for lumbar spine surgery correlates with fewer total medications and less frequent use of vasoactive agents: A single center experience

PLoS ONE ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. e0217939 ◽  
Author(s):  
Hao Deng ◽  
Jean-Valery Coumans ◽  
Richard Anderson ◽  
Timothy T. Houle ◽  
Robert A. Peterfreund
Keyword(s):  
Lumbar Spine ◽  
Spinal Anesthesia ◽  
Spine Surgery ◽  
Lumbar Spine Surgery ◽  
Single Center ◽  
Vasoactive Agents ◽  
Single Center Experience ◽  
Frequent Use

Experiences of spinal anesthesia for previous lumbar spine surgery

2007 ◽  
Vol 24 (Supplement 39) ◽  
pp. 99
Author(s):  
S. Kim ◽  
S J. Lee ◽  
J H. Kim ◽  
Y S. Shin
Keyword(s):  
Lumbar Spine ◽  
Spinal Anesthesia ◽  
Spine Surgery ◽  
Lumbar Spine Surgery
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