gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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The economic impact of anaesthesia methods used in hand surgery: global costs and operating room’s throughput

Meeting Abstract

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  • presenting/speaker Olivier De Boccard - CHUV, service de chirurgie plastique et de la main, Villars-sur-glâne, Switzerland
  • Camillo Mueller - CHUV, service de chirurgie plastique et de la main, Lausanne, Switzerland
  • Thierry Christen - CHUV, service de chirurgie plastique et de la main, Lausanne, Switzerland
  • Wassim Raffoul - CHUV, service de chirurgie plastique et de la main, Lausanne, Switzerland

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-355

doi: 10.3205/19ifssh0697, urn:nbn:de:0183-19ifssh06973

Veröffentlicht: 6. Februar 2020

© 2020 De Boccard et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: There are now growing interests worldwide for the wide awake approach to hand surgery. We hypothesized that using the ‘wide awake, local anaesthesia and no tourniquet’ (WALANT) approach would result in lower global costs and in an increase of the operating room’s efficiency when compared to other types of anaesthesia: axillary brachial plexus block and intravenous regional Anaesthesia

Methods: All cases of single carpal tunnel release and trigger finger release performed between January 2016 and December 2017 in an ambulatory surgery center in Switzerland were divided into three groups, depending on which anaesthesia method was used. Total operating room occupation time, surgical time and the ‘all but surgery’ time were analysed. A common minimal bill per anaesthesia was generated using multiple bills sent to insurance companies.

Results and Conclusions: WALANT allows for an increase in the operating room’s throughput by having shorter occupation times than other methods (17.5-33% depending on the procedure and anaesthesia). Costs of the two procedures are reduced by 21-31% when using WALANT.

Preferring WALANT for some procedures in hand surgery has a notable beneficial impact on the costs and on the operating room’s efficiency. This effect is more evident on short surgical procedures where the surgical time is only a small portion of the total operating room’s occupation time.