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Conscious sedation for brain surgery reduces cost

June 20th, 2010 SindhToday

Washington, June 20 (IANS) The recovery time and cost of brain tumour surgery might be reduced if surgery is performed while patients are awake during part of the procedure, says a study.

The study was conducted at The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

The doctors examined the outcomes of 39 patients treated for glioma, a type of brain tumour that affects about 20,000 Americans annually. They wanted to learn if surgeries that used conscious sedation – in which patients are initially anesthetized but restored to consciousness during surgery on the brain itself – had outcomes different from those using general anaesthesia.

“Our data suggest that patients who received conscious sedation had shorter hospital stays than those receiving general anaesthesia, and this reduced the cost of treatment,” says study leader Dr. E. Antonio Chiocca, professor and chair of neurological surgery and Dardinger Family Endowed Chair in Oncological Neurosurgery.

“This finding needs to be validated with a randomized prospective clinical trial, but if it holds true, it would mean that changing our current way of delivering anaesthesia for these patients could allow them to leave the hospital sooner and save resources,” he added.

Chiocca and his colleagues studied the outcomes of 20 cases that used conscious sedation and compared them with 19 cases that used general anaesthesia.

The investigators evaluated each patient for the number of days they remained in the hospital and for the cost of four items that directly related to the surgery: the cost of the operating room, of anaesthesia, of neurosurgical intensive care and of the hospital room. Each patient was also evaluated for neurological complications.

No significant differences were found in the percentage of complications. Regarding the four costs examined by the investigators, the expense associated with the operating room, anaesthesia and neurosurgical intensive care were the same in both groups.

However, patients receiving conscious sedation had shorter hospital stays after leaving intensive care than did patients receiving general anaesthesia, for a total of 3.5 days and 4.6 days, respectively.

The shorter hospital stay led to an average 36 percent decrease in post-intensive-care direct cost for cases receiving conscious sedation compared with those receiving general anaesthesia.

The study was published online June 18 in the Journal of Neurosurgery.

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