Department of Orthopaedic Surgery, Keck Medical Center of USC, Los Angeles, California, USA.
Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Orthop J Sports Med. 2013 Oct 9;1(5):2325967113505270. doi: 10.1177/2325967113505270. eCollection 2013 Oct.
Anesthetic use for arthroscopic anterior cruciate ligament (ACL) reconstruction may display variability in hospital charges and utilization in the United States.
To evaluate practice patterns and hospital charges for anesthesia in arthroscopic ACL reconstruction.
Cross-sectional study.
The PearlDiver Patient Records Database, a national database of insurance billing records, was searched using the current procedural terminology (CPT) codes for arthroscopic ACL reconstruction in combination with different types of anesthesia. The search included the years between 2004 and 2009. Age, sex, number of procedures performed, geographic region, and hospital charges for each type of anesthesia were recorded and compared. Anesthetic types were categorized as general anesthesia (GA) only, GA with concomitant single femoral injection, GA with concomitant other regional anesthesia (RA), single femoral injection only, or other RA only.
Between 2004 and 2009, a total of 53,968 arthroscopic reconstructive procedures were identified. The mean per patient hospital charge for GA alone, GA in combination with single femoral injection, GA in combination with other RA, single femoral injection alone, and RA alone was $1065 (63% of cases), $1614 (29%), $1849 (4%), $630 (3%), and $612 (1%), respectively. The use of GA in combination with RA or single femoral nerve injection significantly increased during this time period (P = .004 and P < .001, respectively).
The mean per patient hospital charges for arthroscopic ACL reconstruction varied with the mode of anesthesia utilized, where regional anesthetic techniques alone were least expensive. RA alone was utilized infrequently, and there was a significant increase in the rate of utilization of GA in combination with any form of RA.
This study provides information on current trends and hospital charges for anesthesia in arthroscopic ACL reconstruction.
在美国，关节镜下前交叉韧带（ACL）重建的麻醉使用情况在医院收费和使用方面存在差异。
评估关节镜 ACL 重建中麻醉的实践模式和医院收费。
横断面研究。
使用 PearlDiver 患者记录数据库，这是一个全国性的保险计费记录数据库，通过组合不同类型的麻醉，使用关节镜 ACL 重建的当前程序术语（CPT）代码进行搜索。搜索包括 2004 年至 2009 年期间。记录并比较了每种麻醉类型的年龄、性别、手术次数、地理位置和医院收费。将麻醉类型分为单纯全身麻醉（GA）、GA 联合单次股神经注射、GA 联合其他区域麻醉（RA）、单纯单次股神经注射或单纯其他 RA。
在 2004 年至 2009 年间，共确定了 53968 例关节镜重建手术。单纯 GA、GA 联合单次股神经注射、GA 联合其他 RA、单纯单次股神经注射和单纯 RA 的每位患者平均医院收费分别为 1065 美元（63%的病例）、1614 美元（29%）、1849 美元（4%）、630 美元（3%）和 612 美元（1%）。在此期间，GA 联合 RA 或单次股神经注射的使用率显著增加（P =.004 和 P <.001）。
关节镜 ACL 重建每位患者的平均医院收费因所使用的麻醉方式而异，其中单独使用区域麻醉技术费用最低。单独使用 RA 的情况很少见，并且 GA 联合任何形式的 RA 的使用率显著增加。
本研究提供了有关关节镜 ACL 重建中麻醉的当前趋势和医院收费的信息。
