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
Related Articles
- EP ID EP592092
- DOI 10.9790/0853-160204100106.
- Views 86
- Downloads 0
Analysis of Radiological Parameters and Pirani Scoring In Management of Idiopathic Clubfeet by Ponseti Method
BACKGROUND : To final out agreement of association between radiological parameters and pirani scoring in management of idiopathic clubfeet corrected by ponseti method. METHOD : 50 patients of CTEV fulfilling criteria, at...
A Comparative Study to Evaluate Selective COX-2 Inhibitors Alone or in Combination with Pregabalin Given Pre-Operatively For Pain Management in Total Knee Arthroplasty.
Pain control during immediate post operative period is necessary in Total Knee Arthroplasty(TKA) patients for early mobilization. The use of COX-2 inhibitors preoperatively has shown significant reduction in opiod usage...
From Extinct To Life For Conventional Cast Partial Denture: A Case Report
Nowadays , implants are commonly used as a treatment option in partially edentulous conditions than any other treatment options. However there are cases where removable prosthesis are used to treat them due to financial,...
Management of External Inflammatory Cervical Root Resorption Using CBCT And MTA: A Case Report.
Invasive cervical resorption (ICR) is an uncommon form of external root resorption that is often aggressive in nature and often leads to loss of the tooth. This case report describes the successful management of external...
The Impact of Diabetes Mellitus on the Renal Parenchyma Measurements: ACT Based Study
Objective: In order to establish some preliminary data of our population, we determined the Computerized Tomography (CT) for evaluation the kidney dimensions in individuals with known Diabetic Nephropathy. We evaluated w...