Cost-Effectiveness Analysis of Levobupivacaine 0.5 %, a Local Anesthetic, Infusion in the Surgical Wound After Modified Radical Mastectomy

  1. Ferreira Laso, L. 2
  2. López Picado, A. 1
  3. Antoñanzas Villar, F. 3
  4. Lamata de la Orden, L. 4
  5. Ceballos Garcia, M. 1
  6. Ibañez López, C. 1
  7. Pipaon Ruilope, L. 1
  8. Lamata Hernandez, F. 4
  9. Valero Martinez, C. 1
  10. Aizpuru, F. 1
  11. Hernandez Chaves, R. 1
  1. 1 Hospital Universitario Araba
    info

    Hospital Universitario Araba

    Vitoria, España

    ROR https://ror.org/01zc1f144

  2. 2 Hospital San Pedro
    info

    Hospital San Pedro

    Logroño, España

    ROR https://ror.org/031va0421

  3. 3 Universidad de La Rioja
    info

    Universidad de La Rioja

    Logroño, España

    ROR https://ror.org/0553yr311

  4. 4 Hospital Miguel Servet
    info

    Hospital Miguel Servet

    Zaragoza, España

    ROR https://ror.org/01r13mt55

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Revue:
Clinical Drug Investigation

ISSN: 1173-2563

Année de publication: 2015

Volumen: 35

Número: 9

Pages: 575-582

Type: Article

DOI: 10.1007/S40261-015-0316-4 SCOPUS: 2-s2.0-84941180802 WoS: WOS:000360670500005 GOOGLE SCHOLAR

D'autres publications dans: Clinical Drug Investigation

Objectifs de Développement Durable

Résumé

Background and Objective: Effective treatment of postoperative pain contributes to decreasing the rate of complications as well as the total cost of the operated patients. The aim of this study was to analyze the costs and the efficiency of use of continuous infusion of levobupivacaine 0.5 % with the help of an infusion pump in modified radical mastectomy. Methods: A cost calculation of the analgesic procedures (continuous infusion of levobupivacaine 0.5 % [levobupivacaine group (LG)] or saline [saline group (SG)] (2 ml/h 48 h) has been carried out based on the data of a previous clinical trial (double-blind randomized study) of patients who underwent modified radical mastectomy surgery. The measure of the effectiveness was the point reduction of pain derived from the verbal numeric rating scale (VNRS). The usual incremental cost-effectiveness ratio (ICER) was performed. Results: Considering only the intravenous analgesia, overall costs were lower in LG, as less analgesia was used (EUR14.06 ± 7.89 vs. 27.47 ± 14.79; p < 0.001). In this study the costs of the infusion pump were not calculated as it was used by both groups and they offset each other. However, if the infusion pump costs were included, costs would be higher in the LG, (EUR91.89 ± 7.89 vs. 27.47 ± 14.79; p < 0.001) and then the ICER was −8.51, meaning that for every extra point of decrease in the pain verbal numerical rating score over the 2-day period, the cost increased by EUR8.51. Conclusion: Infiltration of local anesthetics is an effective technique for controlling postoperative pain and the associated added costs are relatively low in relation to the total cost of mastectomy, therefore providing patients with a higher quality of care in the prevention of pain. Clinical trials registration: clinicaltrials.gov: reference number NCT01389934. http://clinicaltrials.gov/show/NCT01389934. © 2015, Springer International Publishing Switzerland.