A Cost Effectiveness Analysis Between Intraoperative Non Invasive And Invasive Hemodynamic Monitoring For Supratentorial Tumour Surgery: A Randomized Controlled Trial
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 2
Abstract
Background: Invasive arterial pressure monitoring and central venous pressure monitoring is the mainstay of intraoperative haemodynamic monitoring for assessment during intracranial surgery. However, with the availability of advanced noninvasive monitoring techniques in the present era for such operative procedures, the use of invasive techniques seems to be unnecessary. Hence, a prospective, randomized study has been carried out to see the cost effectiveness of intraoperative invasive versus non-invasive haemodynamic monitoring in patients undergoing craniotomy for supratentorial tumor surgery. Materials: and methods: Eighty-two adult patients (16 – 60 years of age; ASA I and II) were prospectively randomized into Non-invasive (NI) and Invasive (I) groups. Results: In the present study, higher cost consumption was observed in the invasive group (p < 0.001). However, the increased cost of consumption in the invasive group did not translate into greater effectiveness when the two groups were compared as regards haemodynamic fluctuations (>20% of baseline), blood transfusion, vasoactive agents used, Glasgow Outcome Score(GOS) at discharge, return to pre-operative level and length of ICU/hospital stay. The duration of surgery (p=0.033) and anaesthesia (p=0.045) was found to be longer in the invasive group. Conclusion: Invasive haemodynamic monitoring is not cost effective for craniotomy for supratentorial surgery, and can be done with noninvasive haemodynamic monitoring alone; but in large vascular tumors, invasive hemodynamic monitoring may be considered.
Authors and Affiliations
Dr. L. Pradipkumar Singh, Dr N. Ratan Singh, Dr Ashem Jack Meetei, Dr R. S Chouhan, Dr M. P Pandia, Dr H. H Dash
Keywords
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- EP ID EP592092
- DOI 10.9790/0853-160204100106.
- Views 54
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