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[Analysis of cost minimization of epidural anesthesia compared with general anesthesia in oncologic coloproctologic
1Department d'Anestesia i Reanimació, Ciutat Sanitària de Bellvitge, Hospitalet del Llobregat, Barcelona.
Background:
Combined general and epidural anaesthesia in abdominal surgery has shown, both, protective and no effect on final outcome. The aim of this study was to evaluate combined epidural and general anesthesia.
Methods:
One hundred and eighty four patients, diagnosed of neoplastic process, in whom an elective procedure of coloproctologic resection and reconstruction was scheduled during the period between January-1993 and December 1994, were studied. In thirty consecutive patients a combined general-epidural anaesthesia (EA) was performed. These patients were compared to thirty general anaesthesia patients (GA), selected randomly from the same period.
Results:
Both groups were comparable for demographic characteristics and for the type and duration of the surgical procedure. Red Blood Cells units transfused were 1.7 +/- 3 in the EA group and 1.4 +/- 1.9 in the GA group. After the operation, most of patients went to SICU. The length of the hospital stay was 13 +/- 6 days for GA group, while for EA group was .13 +/- 5. The hospital mortality for all operated patients (N = 184) was 1.1%, which were directly related to failure of surgical anastomosis. The need for mechanical ventilation and pulmonary complications were similar in both groups. When analyzing costs, EA group represented a value (pesetas) of 433,501 +/- 183,337 for GA group and 437,735 +/- 149,572 for EA group.
Conclusions:
As shown, in the actual context, we conclude that the anaesthetic technique did not have any influence on outcome or on cost.