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An Economic Analysis of MAC Versus WALANT: A Trigger Finger Release Surgery Case Study
Jason L Codding1, Suneel B Bhat1, Asif M Ilyas1
11 The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA.
Hand (New York, N.Y.)
|June 24, 2017
Summary
Wide awake hand surgery (WALANT) reduced recovery time and costs compared to monitored anesthesia care (MAC) for trigger finger release. WALANT offers significant savings for high-volume procedures.
Area of Science:
- Hand Surgery
- Anesthesiology
- Health Economics
Background:
- Wide awake local anesthesia with no tourniquet (WALANT) is gaining interest for hand surgery.
- A study hypothesized WALANT reduces hospital time and cost versus monitored anesthetic care (MAC).
Purpose of the Study:
- To compare the efficiency and cost-effectiveness of WALANT versus MAC for single trigger finger release (TFR) surgery.
Main Methods:
- A comparative analysis of consecutive single TFR surgeries under MAC and WALANT.
- Data collected included operating room (OR) time, surgical time, recovery time, and anesthesia costs.
- Surgeries were performed by the same surgeon at the same facility.
Main Results:
- WALANT cases averaged 2 minutes less OR time than MAC (25.2 vs. 27.2 minutes).
- Surgical times were similar (10.4 vs. 10.2 minutes).
- WALANT significantly reduced recovery room time (30.2 vs. 72.3 minutes) and incurred lower anesthesia charges ($105 minimum excess for MAC).
Conclusions:
- WALANT for TFR surgery trended toward less OR time, similar surgical duration, and significantly reduced recovery time compared to MAC.
- This approach results in lower indirect costs and potential systemic savings for payers.
- Avoiding sedation in high-volume procedures like TFR can be increasingly important for cost savings in healthcare.
