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Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Cost Analysis

BACKGROUND: We recently performed a clinical trial comparing motor sparing blocks (MSB) to periarticular infiltration (PAI) following total knee arthroplasty (TKA). We found that MSBs provided longer analgesia (8.8 hours) than PAI with retention of quadriceps strength, and with similar function, sat...

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Autores principales: Sogbein, Olawale A, Marsh, Jacquelyn D, Somerville, Lyndsay E, Howard, James L, Lanting, Brent A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9309562/
https://www.ncbi.nlm.nih.gov/pubmed/35898800
http://dx.doi.org/10.2147/ORR.S361556
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author Sogbein, Olawale A
Marsh, Jacquelyn D
Somerville, Lyndsay E
Howard, James L
Lanting, Brent A
author_facet Sogbein, Olawale A
Marsh, Jacquelyn D
Somerville, Lyndsay E
Howard, James L
Lanting, Brent A
author_sort Sogbein, Olawale A
collection PubMed
description BACKGROUND: We recently performed a clinical trial comparing motor sparing blocks (MSB) to periarticular infiltration (PAI) following total knee arthroplasty (TKA). We found that MSBs provided longer analgesia (8.8 hours) than PAI with retention of quadriceps strength, and with similar function, satisfaction, and length hospital stay. However, its potential increased cost could serve as a barrier to its adoption. Therefore, our aim was to compare the costs of MSBs to PAI following TKA. METHODS: We conducted a retrospective review of data from our previous RCT. There were 82 patients included in the RCT (n = 41 MSB group, n = 41 PAI group). We compared the mean total costs associated with each group until hospital discharge including intervention costs, health-care professional service fees, intraoperative medications, length of stay, and postoperative opioid use. RESULTS: Seventy patients were included (n = 35 MSB group, n = 35 PAI group). The mean total costs for the MSB group were significantly higher ($1959.46 ± 755.4) compared to the PAI group ($1616.25 ± 488.33), with a mean difference of $343.21 (95% CI = $73.28 to $664.11, p = 0.03). The total perioperative intervention costs for performing the MSB was also significantly higher; however, postoperative inpatient costs including length of stay and total opioid use did not differ significantly. CONCLUSION: Motor sparing blocks had significantly higher mean total and perioperative costs compared to PAI with no significant difference in postoperative inpatient costs. However, its quadricep sparing nature and previously demonstrated prolonged postoperative analgesia can be used to facilitate an outpatient TKA pathway thereby offsetting its increased costs.
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spelling pubmed-93095622022-07-26 Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Cost Analysis Sogbein, Olawale A Marsh, Jacquelyn D Somerville, Lyndsay E Howard, James L Lanting, Brent A Orthop Res Rev Original Research BACKGROUND: We recently performed a clinical trial comparing motor sparing blocks (MSB) to periarticular infiltration (PAI) following total knee arthroplasty (TKA). We found that MSBs provided longer analgesia (8.8 hours) than PAI with retention of quadriceps strength, and with similar function, satisfaction, and length hospital stay. However, its potential increased cost could serve as a barrier to its adoption. Therefore, our aim was to compare the costs of MSBs to PAI following TKA. METHODS: We conducted a retrospective review of data from our previous RCT. There were 82 patients included in the RCT (n = 41 MSB group, n = 41 PAI group). We compared the mean total costs associated with each group until hospital discharge including intervention costs, health-care professional service fees, intraoperative medications, length of stay, and postoperative opioid use. RESULTS: Seventy patients were included (n = 35 MSB group, n = 35 PAI group). The mean total costs for the MSB group were significantly higher ($1959.46 ± 755.4) compared to the PAI group ($1616.25 ± 488.33), with a mean difference of $343.21 (95% CI = $73.28 to $664.11, p = 0.03). The total perioperative intervention costs for performing the MSB was also significantly higher; however, postoperative inpatient costs including length of stay and total opioid use did not differ significantly. CONCLUSION: Motor sparing blocks had significantly higher mean total and perioperative costs compared to PAI with no significant difference in postoperative inpatient costs. However, its quadricep sparing nature and previously demonstrated prolonged postoperative analgesia can be used to facilitate an outpatient TKA pathway thereby offsetting its increased costs. Dove 2022-07-19 /pmc/articles/PMC9309562/ /pubmed/35898800 http://dx.doi.org/10.2147/ORR.S361556 Text en © 2022 Sogbein et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Sogbein, Olawale A
Marsh, Jacquelyn D
Somerville, Lyndsay E
Howard, James L
Lanting, Brent A
Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Cost Analysis
title Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Cost Analysis
title_full Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Cost Analysis
title_fullStr Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Cost Analysis
title_full_unstemmed Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Cost Analysis
title_short Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Cost Analysis
title_sort ultrasound-guided motor-sparing knee blocks for postoperative analgesia following total knee arthroplasty: a cost analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9309562/
https://www.ncbi.nlm.nih.gov/pubmed/35898800
http://dx.doi.org/10.2147/ORR.S361556
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