Research Article
BibTex RIS Cite

Retrospective evaluation of functional results and cost analysis of two different anesthesia methods in carpal tunnel syndrome surgery

Year 2024, Volume: 10 Issue: 6, 568 - 574
https://doi.org/10.18621/eurj.1403401

Abstract

Objective: The provision of health services at a satisfactory level and low cost is the main objective of all health systems. For this purpose, we evaluated carpal tunnel surgery performed under local anesthesia in the local procedure room and under a laryngeal mask in the operating room in terms of cost analysis. In this way, we aimed to reveal the controllability of health service expenditures and inadequacies in costing.

Methods: A total of 119 patients who underwent local anesthesia (LA) in the local procedure room (Group I) and 45 patients who underwent laryngeal mask anesthesia (LMA) in the operating room (Group II) were retrospectively evaluated. In the calculation of cost analysis, since there were no hospitalization procedures in Group I cases, total costs were calculated only in minutes, multiplied by a coefficient of 7. In Group II cases, total costs were calculated by multiplying total procedure times in minutes by a coefficient of 12 and adding 50 units of hospitalization cost.

Results: Postoperative Quick Disabilities of the Arm, Shoulder, and Hand score is statistically similar in both groups (P=0.714). The operation duration has an average value of 15.39±2.37 in the group of patients who received local anesthesia and 29.71±4.78 in the group treated in the operating room (P<0.001). It has been found that the intervention performed in the operating room is 2.2 times more costly than the local intervention.

Conclusion: Our study is extremely valuable in terms of demonstrating that health service expenditures can be controlled in appropriately selected patients.

References

  • 1. Carrin G. Social health i̇nsurance i̇n developing countries: a continuing challenge. Int Soc Secur Rev. 2002;55(2):57-69. doi: 10.1111/1468-246X.00124.
  • 2. Nuckols TK, Dworsky M, Conlon C, et al. The quality of occupational healthcare for carpal tunnel syndrome, healthcare expenditures, and disability outcomes: A prospective observational study. Muscle Nerve. 2023;67(1):52-62. doi: 10.1002/mus.27718.
  • 3. Drechsler D. Jütting Jp. Empirical and economic underpinnings. Global marketplace for private health insurance: Strength i̇n numbers. Eds: Preker As. Zweifel P. Schellekens. The World Bank Washington, D.C. 2010:27-99.
  • 4. Luckhaupt SE, Dahlhamer JM, Ward BW, Sweeney MH, Sestito JP, Calvert GM. Prevalence and work‐relatedness of carpal tunnel syndrome in the working population, United States, 2010 National Health Interview Survey. Am J Ind Med. 2013;56(6):615‐624. doi: 10.1002/ajim.22048.
  • 5. Zhang S, Vora M, Harris AH, Baker L, Curtin C, Kamal RN. Cost-Minimization Analysis of Open and Endoscopic Carpal Tunnel Release. J Bone Joint Surg Am. 2016;98(23):1970-1977. doi: 10.2106/JBJS.16.00121.
  • 6. D'Arcy CA, McGee S. The rational clinical examination. Does this patient have carpal tunnel syndrome? JAMA. 2000;283(23):3110-3117. doi: 10.1001/jama.283.23.3110.
  • 7. Foster BD, Sivasundaram L, Heckmann N, et al. Surgical Approach and Anesthetic Modality for Carpal Tunnel Release: A Nationwide Database Study With Health Care Cost Implications. Hand (N Y). 2017;12(2):162-167. doi: 10.1177/1558944716643276.
  • 8. Kazmers NH, Presson AP, Xu Y, Howenstein A, Tyser AR. Cost Implications of Varying the Surgical Technique, Surgical Setting, and Anesthesia Type for Carpal Tunnel Release Surgery. J Hand Surg Am. 2018;43(11):971-977.e1. doi: 10.1016/j.jhsa.2018.03.051.
  • 9. Ibrahim T, Majid I, Clarke M, Kershaw CJ. Outcome of carpal tunnel decompression: the influence of age, gender, and occupation. Int Orthop. 2009;33(5):1305-1309. doi: 10.1007/s00264-008-0669-x.
  • 10. Via GG, Esterle AR, Awan HM, Jain SA, Goyal KS. Comparison of Local-Only Anesthesia Versus Sedation in Patients Undergoing Staged Bilateral Carpal Tunnel Release: A Randomized Trial. Hand (N Y). 2020;15(6):785-792. doi: 10.1177/1558944719836237.
  • 11. Lalonde D. Minimally invasive anesthesia in wide awake hand surgery. Hand Clin. 2014;30(1):1-6. doi: 10.1016/j.hcl.2013.08.015.
  • 12. Sørensen AM, Dalsgaard J, Hansen TB. Local anaesthesia versus intravenous regional anaesthesia in endoscopic carpal tunnel release: a randomized controlled trial. J Hand Surg Eur Vol. 2013;38(5):481-484. doi: 10.1177/1753193412453664.
  • 13. Via GG, Esterle AR, Awan HM, Jain SA, Goyal KS. Comparison of Local-Only Anesthesia Versus Sedation in Patients Undergoing Staged Bilateral Carpal Tunnel Release: A Randomized Trial. Hand (N Y). 2020;15(6):785-792. doi: 10.1177/1558944719836237.
  • 14. Kazmers NH, Presson AP, Xu Y, Howenstein A, Tyser AR. Cost Implications of Varying the Surgical Technique, Surgical Setting, and Anesthesia Type for Carpal Tunnel Release Surgery. J Hand Surg Am. 2018;43(11):971-977.e1. doi: 10.1016/j.jhsa.2018.03.051.
  • 15. Becker GS. The Market For Health Insurance. Essentials Of Health Economics. Eds: Dewar Dm. Jones And Bartlett Publishers, 2010: pp. 31-40.
Year 2024, Volume: 10 Issue: 6, 568 - 574
https://doi.org/10.18621/eurj.1403401

Abstract

References

  • 1. Carrin G. Social health i̇nsurance i̇n developing countries: a continuing challenge. Int Soc Secur Rev. 2002;55(2):57-69. doi: 10.1111/1468-246X.00124.
  • 2. Nuckols TK, Dworsky M, Conlon C, et al. The quality of occupational healthcare for carpal tunnel syndrome, healthcare expenditures, and disability outcomes: A prospective observational study. Muscle Nerve. 2023;67(1):52-62. doi: 10.1002/mus.27718.
  • 3. Drechsler D. Jütting Jp. Empirical and economic underpinnings. Global marketplace for private health insurance: Strength i̇n numbers. Eds: Preker As. Zweifel P. Schellekens. The World Bank Washington, D.C. 2010:27-99.
  • 4. Luckhaupt SE, Dahlhamer JM, Ward BW, Sweeney MH, Sestito JP, Calvert GM. Prevalence and work‐relatedness of carpal tunnel syndrome in the working population, United States, 2010 National Health Interview Survey. Am J Ind Med. 2013;56(6):615‐624. doi: 10.1002/ajim.22048.
  • 5. Zhang S, Vora M, Harris AH, Baker L, Curtin C, Kamal RN. Cost-Minimization Analysis of Open and Endoscopic Carpal Tunnel Release. J Bone Joint Surg Am. 2016;98(23):1970-1977. doi: 10.2106/JBJS.16.00121.
  • 6. D'Arcy CA, McGee S. The rational clinical examination. Does this patient have carpal tunnel syndrome? JAMA. 2000;283(23):3110-3117. doi: 10.1001/jama.283.23.3110.
  • 7. Foster BD, Sivasundaram L, Heckmann N, et al. Surgical Approach and Anesthetic Modality for Carpal Tunnel Release: A Nationwide Database Study With Health Care Cost Implications. Hand (N Y). 2017;12(2):162-167. doi: 10.1177/1558944716643276.
  • 8. Kazmers NH, Presson AP, Xu Y, Howenstein A, Tyser AR. Cost Implications of Varying the Surgical Technique, Surgical Setting, and Anesthesia Type for Carpal Tunnel Release Surgery. J Hand Surg Am. 2018;43(11):971-977.e1. doi: 10.1016/j.jhsa.2018.03.051.
  • 9. Ibrahim T, Majid I, Clarke M, Kershaw CJ. Outcome of carpal tunnel decompression: the influence of age, gender, and occupation. Int Orthop. 2009;33(5):1305-1309. doi: 10.1007/s00264-008-0669-x.
  • 10. Via GG, Esterle AR, Awan HM, Jain SA, Goyal KS. Comparison of Local-Only Anesthesia Versus Sedation in Patients Undergoing Staged Bilateral Carpal Tunnel Release: A Randomized Trial. Hand (N Y). 2020;15(6):785-792. doi: 10.1177/1558944719836237.
  • 11. Lalonde D. Minimally invasive anesthesia in wide awake hand surgery. Hand Clin. 2014;30(1):1-6. doi: 10.1016/j.hcl.2013.08.015.
  • 12. Sørensen AM, Dalsgaard J, Hansen TB. Local anaesthesia versus intravenous regional anaesthesia in endoscopic carpal tunnel release: a randomized controlled trial. J Hand Surg Eur Vol. 2013;38(5):481-484. doi: 10.1177/1753193412453664.
  • 13. Via GG, Esterle AR, Awan HM, Jain SA, Goyal KS. Comparison of Local-Only Anesthesia Versus Sedation in Patients Undergoing Staged Bilateral Carpal Tunnel Release: A Randomized Trial. Hand (N Y). 2020;15(6):785-792. doi: 10.1177/1558944719836237.
  • 14. Kazmers NH, Presson AP, Xu Y, Howenstein A, Tyser AR. Cost Implications of Varying the Surgical Technique, Surgical Setting, and Anesthesia Type for Carpal Tunnel Release Surgery. J Hand Surg Am. 2018;43(11):971-977.e1. doi: 10.1016/j.jhsa.2018.03.051.
  • 15. Becker GS. The Market For Health Insurance. Essentials Of Health Economics. Eds: Dewar Dm. Jones And Bartlett Publishers, 2010: pp. 31-40.
There are 15 citations in total.

Details

Primary Language English
Subjects Orthopaedics
Journal Section Original Articles
Authors

Bilal Aykaç 0000-0002-6180-2467

Early Pub Date March 25, 2024
Publication Date
Submission Date December 11, 2023
Acceptance Date February 25, 2024
Published in Issue Year 2024 Volume: 10 Issue: 6

Cite

AMA Aykaç B. Retrospective evaluation of functional results and cost analysis of two different anesthesia methods in carpal tunnel syndrome surgery. Eur Res J. 10(6):568-574. doi:10.18621/eurj.1403401

e-ISSN: 2149-3189 


The European Research Journal, hosted by Turkish JournalPark ACADEMIC, is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

by-nc-nd.png

2024