Brighton Anaesthesia Research Forum, Department of Anaesthesia, Royal Sussex County Hospital, Brighton, East Sussex, UK.
Anaesthesia. 2010 Aug;65(8):810-4. doi: 10.1111/j.1365-2044.2010.06382.x. Epub 2010 May 27.
It remains uncertain whether spinal anaesthesia is preferable to general anaesthesia for surgical repair of hip fracture, but one determining factor is the comparative cost. A detailed cost analysis relating to 20 consultants' intended anaesthetic practice (which provided information of consumables used) and data from the Brighton Hip Fracture Database was performed to quantify any difference in the costs of administering spinal versus general anaesthesia for patients with hip fracture. Although spinal anaesthesia took significantly longer to administer (mean (SD) time 31 (15) min vs 27 (16) min; p < 0.0001), the mean (SD) cost of spinal anaesthesia (193.81 pounds (37.49)) was significantly less than the cost of general anaesthesia (270.58 pounds (44.68); p < 0.0001). The mean percentage cost of anaesthesia was 3.8% of hospital income per hip fracture, and personnel contributed approximately 46% of this cost. While such considerations indicate that spinal anaesthesia is financially preferable, it is unknown whether differential clinical outcomes between regional and general anaesthesia may offset this apparent monetary advantage.
对于髋关节骨折的手术修复，椎管内麻醉是否优于全身麻醉仍不确定，但一个决定因素是比较成本。我们对 20 位顾问的拟议麻醉实践（提供了使用的耗材信息）进行了详细的成本分析，并结合布赖顿髋关节骨折数据库的数据，对接受椎管内麻醉与全身麻醉的髋关节骨折患者的成本差异进行了量化。尽管椎管内麻醉的给药时间明显更长（平均（标准差）时间为 31（15）分钟与 27（16）分钟；p < 0.0001），但椎管内麻醉的平均（标准差）成本（193.81 英镑（37.49））明显低于全身麻醉的成本（270.58 英镑（44.68）；p < 0.0001）。麻醉的平均费用占每个髋关节骨折医院收入的 3.8%，人员费用约占该成本的 46%。虽然这些考虑表明椎管内麻醉在经济上更可取，但尚不清楚局部麻醉和全身麻醉之间的临床结果差异是否会抵消这种明显的货币优势。
