Abstract
To evaluate the cost and time effectiveness for different anesthesia methods when performing knee arthroscopy, this study compared three different anesthesia methods. Four hundred healthy patients scheduled for knee arthroscopy were randomized to either local anesthesia (LA) (n=200), spinal anesthesia (SA) (n=100) or general anesthesia (GA) (n=100). The LA arthroscopies were performed in a facility set up in our outpatient department without anesthesia service. The SA and GA arthroscopies were performed in our central operating department with full anesthesia service. Comparisons were made between total hospital stay, anesthesia time, surgery time, recovery time, pharmaceutical and total cost. The total hospital time was 130.4 min (SD 35.14, range 63–383) in the LA group compared to 280.4 min (SD 79.29, range 155–589) in the GA group (p<0.001). The total hospital time in the GA group was also shorter than that of 350.3 min (SD 65.37, range 198–502) in the SA group (p<0.001). The time from start of anesthesia to start of surgery was significantly longer in the LA group, 39.2 min (SD 13.13, range 17–87), compared to 20.1 min (SD 4.93, range 11–35) in the SA group and to 17.6 min (SD 4.64, range 9–44) in the GA group. There were no differences in the surgery time for the three groups. The use of LA was shown to save SEK 1011 (Swedish Crowns) per patient compared to SA and GA.
Similar content being viewed by others
References
Bonicalzi V, Gallino M (1995) Comparison of two regional anesthetic techniques for knee arthroscopy. Arthroscopy 11:207–212
Brimson J (1991) Activity accounting: an activity-based costing approach. Wiley, New York
Cardosa M, Rudkin GE, Osborne GA (1994) Outcome from day-case knee arthroscopy in a major teaching hospital. Arthroscopy 10:624–629
Casati A, Cappelleri G, Berti M, Fanelli G, Di Benedetto P, Torri G (2002) Randomized comparison of remifentanil-propofol with a sciatic-femoral nerve block for out-patient knee arthroscopy. Eur J Anaesthesiol 19:109–114
Forssblad M, Weidenhielm L (1999) Knee arthroscopy in local versus general anaesthesia. The incidence of rearthroscopy. Knee Surg Sports Traumatol Arthrosc 7:323–326
Hansson S, Nilsson S-Å (1998) Produktkalkylering. Liber, Stockholm
Heidvall M, Hein A, Davidson S, Jakobsson J (2000) Cost comparison between three different general anaesthetic techniques for elective arthroscopy of the knee. Acta Anaesthesiol Scand 44:157–162
Jacobson E, Forssblad M, Rosenberg J, Westman L, Weidenhielm L (2000) Can local anesthesia be recommended for routine use in elective knee arthroscopy? A comparison between local, spinal, and general anesthesia. Arthroscopy 16:183–190
Jacobson E, Forssblad M, Weidenhielm L, Renström P (2002) Knee arthroscopy with the use of local anesthesia—an increased risk for repeat arthroscopy? A prospective, randomized study with a six-month follow-up. Am J Sports Med 30:61–65
Lintner S, Shawen S, Lohnes J, Levy A, Garrett W (1996) Local anesthesia in outpatient knee arthroscopy: a comparison of efficacy and cost. Arthroscopy 12:482–488
Martikainen M, Kangas-Saarela T, Lopponen A, Ohtonen P, Salomaki T (2001) Two percent lidocaine spinal anaesthesia compared with sevoflurane anaesthesia in ambulatory knee surgery-cost-effectiveness, home readiness and recovery profiles. Ambul Surg 9:77–81
Munk S, Pedersen KM (1994) Knee arthroscopy under local anesthesia with or without anesthesiologic assistance. A cost-benefit analysis. Ugeskr Laeger 156:313–316
Pellacci F, Beluzzi R, Martini A (1996) Out-patient arthroscopy. Chir Organi Mov 81:165–172
Ries CR, Azmudeh A, Franciosi LG, Schwarz SK, MacLeod BA (1999) Cost comparison of sevoflurane with isoflurane anesthesia in arthroscopic menisectomy surgery. Can J Anaesth 46:1008–1013
Shapiro MS, Safran MR, Crockett H, Finerman GA (1995) Local anesthesia for knee arthroscopy. Efficacy and cost benefits. Am J Sports Med 23:50–53
Trieshmann HW (1996) Knee arthroscopy: a cost analysis of general and local anesthesia. Arthroscopy 12:60–63
Williams CR, Thomas NP (1997) A prospective trial of local versus general anaesthesia for arthroscopic surgery of the knee. Ann R Coll Surg Engl 79:345–348
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Forssblad, M., Jacobson, E. & Weidenhielm, L. Knee arthroscopy with different anesthesia methods: a comparison of efficacy and cost. Knee Surg Sports Traumatol Arthrosc 12, 344–349 (2004). https://doi.org/10.1007/s00167-004-0523-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00167-004-0523-7