References

  1. Frost and Sullivan. The New Economies of Healthcare: Evaluating Medical Technologies based on actual value as a growth strategy for healthcare providers. Charlie Whelan
  2. Institute of Medicine of the National Academies Report. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, 2011. The National Academies Press, Washington DC (page 260).
  3. Sinclair DR, Chung F, Mezei G. Can postoperative nausea and vomiting be predicted? Anesthesiology 1999;91:109–18
  4. Williams BA, Motolenich P, Kenter ML. Hospital Facilities and Resource Management: Economic Impact of a High-Volume Regional Anesthesia Program for Outpatients. Int Anesthesiol Clin. 2005 Summer; 43(3):43-51.
  5. Carroll et al, J Clin Anesth, 1994. Costs Incurred by Outpatient Surgical Centers in Managing Postoperative Nausea and Vomiting.
  6. Williams, et al, Anesthesiology 2004. Economics of Nerve Block Pain Management after Anterior Cruciate Ligament Reconstruction.
  7. Hebl J, Kopp S, Horlocker T, et al. A comprehensive protocol that emphasizes peripheral nerve blockade for total knee and total hip arthroplasty. J Bone Joint Surg Am. 87:63-70; 2005.
  8. Mears DC. Mears SC. Chelly JE. Dai F. Vulakovich KL. Clinical Orthopaedics & Related Research. 467(6):1412-7, 2009 Jun.
  9. Cohen NP, Levine WN, Marra G, et al. Indwelling interscalene catheter anesthesia in the surgical management of stiff shoulder: a report of 100 consecutive cases. J Shoulder Elbow Surgery. 2000;9:268-274.
  10. Grant S, Nielsen K, Greengrass R, et al. Continuous peripheral nerve block for ambulatory surgery.  Reg Anesth Pain Med. 2001; 26:209-214
  11. David Nelson. The Impact of Regional Anesthesia on Perioperative Outcomes. 2011. Article written for www.RAAdvantages.com
  12. Mark Dalton. M.D. Orthopedic Foot and Ankle. Video interview for www.RAAdvantages.com.
  13. Kehlet H, Wilmore DW. Multimodal strategies to improve the surgical outcome. AM J Surg. 2002;183:630-641.
  14. Liu SS. Strodtbeck WM, Richman JM. Wu CL. A comparison of regional versus general anesthesia for ambulatory anesthesia: A meta-analysis of randomized control trials. Anesth Analg. 2005 Dec;101(6):1634-42.
  15. Rodgers A, Walker N, Schug S, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ. 2000;321:1493-1497.
  16. Clinical and Economic Implications Related to Postsurgical Analgesic Devices.  Hospital Pharmacy, 2011; 46(6 Suppl 1): S12-S20
  17. An anesthesiologist’s perspective on inhaled anesthesia decision-making. AM J Health-System Pharm – Vol 67 Apr 15, 2010 Suppl 4
  18. Effect of postoperative analgesia on surgical outcome.  H Kehlet and K Holte. Br J Anaesth 2001; 87: 62-72
  19. Oderda GM et al. Ann Pharmacother 2007;41:400-7.
  20. Takahashi S, Kushikata T, Matsuki A. Effects of Isoflurane and Ketamine on sleep in rabbits. Psychiatry Clinical Neuroscience. 2001;55:239-240.
  21. Morrison RS et al. J Gerontol. 2003; 58:76-81.
  22. Asgeursson T et al. J Am Coll Surgery. 2010;210:228-31.
  23. Postoperative Respiratory Depression and Opioids. F. Overdyk.  Initiatives in Safe Patient Care
  24. Hadzic A, Karaca P, Hobeika, et al. Peripheral nerve blocks result in superior recovery profile compared with general anesthesia in outpatient knee arthroscopy. Anesth Analg. 2005; 100: 976-81.
  25. D’Alessio JG, Rosenblum M, Shea KP, et al. A retrospective comparison of interscalene block and general anesthesia for ambulatory surgery shoulder arthroscopy. Reg Anesth. 1995;20:62-68.
  26. Apfelbaum JL, Chen C, Mehta SS, et al. Postoperative pain experience. Results from a national survey suggest postoperative pain continues to be undermanaged. Anesth & Analg. 2003;97:534-540
  27. Hill RP, et al.  Cost-effectiveness of Prophylactic Antiemetic Therapy with Ondansetron, Droperidol, or Placebo.  Anesthesiology 2000
  28. Tomcanin R.  Are Hidden Costs Hurting You:  A Regional Anesthesia Approach to Reduce Complications and Cost at ASCs.  www.beckersasc.com 2010
  29. Spyropoulos AC, Lin J. Direct medical costs of venous thromboembolism and subsequent hospital readmission rates: an administrative claims analysis from 30 managed care organizations. J Manag Care Pharm. 2007;13:475-86
  30. Mahoney CB, Odom J. Maintaining intraoperative normothermia: a meta-analysis of outcomes with costs. AANA J. 1999;67:155-63
  31. Carroll NV, Miederhoff P, Cox FM, et al. Postoperative Nausea and Vomiting after Discharge from Outpatient Surgery Centers. Anesthesia Analgesia. 1995;80:903-909.
  32. http://www.beckersasc.com/asc-transactions-and-valuation-issues/10-key-trends-for-surgery-centers-in-2011.html
  33. What does one minute of operating room time cost? Journal of Clinical Anesthesia (2010) 22, 233–236.
  34. Coley KC et al. J Clinical Anesthesia. 2002; 14:349-53.
  35. Does Continuous PNB Provide Superior Pain Control to Opioids? A Meta Analysis. Anesth Analg 2006; 102:248-57.
  36. Ilfeld BM, Morey TE, Wang RD, et al. Continuous popliteal sciatic nerve block for postoperative pain control at home: a randomized, double-blinded, placebo controlled study. Anesthesiology. 2002;97:959-965.
  37. Effect of postoperative analgesia on surgical outcome.  H Kehlet and K Holte. Br J Anaesth 2001; 87: 62-72
  38.   Ahn H, Bronge A, Johansson K, Ygge H, Lindhagen J. Effect of continuous post operative analgesia on intestinal motility. Br J Surg 1988; 75: 1176-8.
  39. Cohen NP, Levine WN, Marra G, et al. Indwelling interscalene catheter anesthesia in the surgical management of stiff shoulder: a report of 100 consecutive cases. J Shoulder Elbow Surgery. 2000;9:268-274
  40. Wu CL, Naqibuddin M, Fleisher LA. Measurement of Patient satisfaction as an outcome of regional anesthesia and analgesia: a systematic review. Reg Anesth Pain Med. 2001;26:196-208.
  41. Hadzic A, Arliss J, Kerimoglu B, et al. A comparison of infraclavicular nerve block  versus general anesthesia for hand and wrist day-case surgeries. Anesthesiology. 2004; 101:127-132.
  42. Capdevila X, Barthelet Y, Biboulet P, et al. Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery.  Anesthesiology. 1999;91:8-15.
  43. Ilfeld B, Morey T, Enneking K, et al. Continuous infraclavicular brachial plexus block for postoperative pain control at home: a randomized, double blinded, placebo-controlled study.  Anesthesiology. 2002;96:1297-1304.
  44.  Neilsen K, Greengrass R, Pietrobon R, et al.  Continuous interscalene brachial plexus blockade provides good analgesia at home after major shoulder surgery report of four cases.  Can J Anaesth. 2003:50:57-61.
  45.  Ilfeld B, Marey T, Enneking F.  Continuous infraclavicular brachial plexus block for postoperative pain control at home:  a randomized, double-blinded, placebo-controlled study.  Anesthesiology.  2002;96: 1297-1304.
  46. Klein S, Bergh A, Steele S, et al.  Thoracic paravertebral block for breast surgery.  Anesth Analg.  1999; 88:508-517.
  47.  Coveney E, Weltz C, Greengrass R, et al.  Use of paravertebral block anesthesia in the surgical management of breast cancer:  experience in 156 cases.  Ann Surg. 1998; 227: 496-501.
  48.  Singelyn F, Deyaert M, Joris D, et al. Effects of patient-controlled analgesia with morphine, continuous epidural analgesia, and continuous three-in-one block on postoperative pain and knee rehabilitation after unilateral total knee arthroplasty. Anesth Analg. 1998:88-92.
  49. Sinclair DR, Chung F, Mezei G. Can postoperative nausea and vomiting be predicted? Anesthesiology 1999;91:109–18
  50. Macario A., Weinger M, Carney S, et al. Which clinical anesthesia outcomes are  important to avoid? The Perspective of Patients. Anesth Analg. 1999; 89:652-658
  51.  Benefit and outcome after epidural analgesia. Continuing Education in Anaesthesia, Critical Care & Pain. Volume 4, Number 2, 2004
  52. Nielsen et al. Outcomes after RA. Int Anesthesiol Clin. 2005 Summer; 43(3):96.
  53. Chelly et al. Continuous femoral blocks improve recovery and outcome of patients undergoing total knee arthroplasty. The Journal of Arthroplasty. 2000 July;16:436-445.
  54. Klein SM, Nielsen KC, Greengrass RA, et al. Ambulatory discharge after long –acting peripheral nerve blockade: 2382 blocks with ropivicaine. Anesth Analg. 2002;94: 65-70
  55. Hadzic A, Karaca P, Hobeika, et al. Peripheral nerve blocks result in superior recovery profile compared with general anesthesia in outpatient knee arthroscopy. Anesth Analg. 2005; 100: 976-81.
  56. Outpatient Surgery Magazine, “Rev up Your Recovery Room,” November, 2008. Vol. IX, No. 11.
Close


$141.51

Cost of PONV Complications:
35% of extended PACU stays are caused by episodes of PONV.
Outpatient Surgery, November 2008


Sed posuere consectetur est at lobortis blandit tempus.
Curabitur blandit tempus porttitor

0
Sed posuere consectetur est at lobortis blandit tempus.
Curabitur blandit tempus porttitor

$194.00
Sed posuere consectetur est at lobortis blandit tempus.
Curabitur blandit tempus porttitor

$0.00
Sed posuere consectetur est at lobortis blandit tempus.
Curabitur blandit tempus porttitor

$0.00

$194.00

0
Sed posuere consectetur est at lobortis blandit tempus.
Curabitur blandit tempus porttitor

$0.00

Cost of PONV / yr
$0.00

Cost of Pain Complications: Sed posuere consectetur est at lobortis blandit tempus.
Curabitur blandit tempus porttitor

Sed posuere consectetur est at lobortis blandit tempus.
Curabitur blandit tempus porttitor

0
Sed posuere consectetur est at lobortis blandit tempus.
Curabitur blandit tempus porttitor

$105.00
Sed posuere consectetur est at lobortis blandit tempus.
Curabitur blandit tempus porttitor

$0.00
Sed posuere consectetur est at lobortis blandit tempus.
Curabitur blandit tempus porttitor

$0.00

$105.00

0
Sed posuere consectetur est at lobortis blandit tempus.
Curabitur blandit tempus porttitor

$0.00

Cost of Pain / yr
$0.00

The Cost Savings Calculator demonstrates the effect Regional Anesthesia can have on patient recovery and a facility’s bottom line. The calculator focuses on the two most common post-op adverse events causing extended PACU stays or delayed discharge: PONV and Pain.56

With this tool, facilities can quantify the cost of avoidable events, calculate the associated profit erosion, and then discover how these hidden costs may be affecting them.

The first step is to identify the significance of these losses within a practice. Then, once documented, share the findings and create a team to focus on containing these costs.

*CPT codes cited are for illustrative purposes only. Providers are responsible for assigning accurate and appropriate CPT codes. B. Braun makes no representation as to the CPT code cited.