MP34-16 SWITCHING FROM SEDATION TO LOCAL ANAESTHETIC TRANSPERINEAL PROSTATE BIOPSIES: A COST-BENEFIT ANALYSIS

Abstract

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety II (MP34)1 Sep 2021MP34-16 SWITCHING FROM SEDATION TO LOCAL ANAESTHETIC TRANSPERINEAL PROSTATE BIOPSIES: A COST-BENEFIT ANALYSIS Uma Walters, Martin J Connor, Edward J Bass, David Eldred-Evans, William Maynard, Pallab Sarkar, Mariana Bertoncelli Tanaka, Henry Tam, Mathias Winkler, and Hashim U Ahmed Uma WaltersUma Walters More articles by this author , Martin J ConnorMartin J Connor More articles by this author , Edward J BassEdward J Bass More articles by this author , David Eldred-EvansDavid Eldred-Evans More articles by this author , William MaynardWilliam Maynard More articles by this author , Pallab SarkarPallab Sarkar More articles by this author , Mariana Bertoncelli TanakaMariana Bertoncelli Tanaka More articles by this author , Henry TamHenry Tam More articles by this author , Mathias WinklerMathias Winkler More articles by this author , and Hashim U AhmedHashim U Ahmed More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002043.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transperineal prostate biopsy (TPB) can be performed under local anaesthetic (LA), LA and sedation (S) or general anaesthetic (GA). The method used depends on patient preference, tolerability, theatre/office-space availability and anaesthetic risk factors. The aim of this study was to investigate the cost-benefit analysis of performing all S-TPBs under LA alone. METHODS: 664 consecutive men undergoing TPB were identified from a prospective prostate cancer registry. NHS tariff payment for TPB is £1,088/biopsy. Costs were derived from NHS employers: £94.46 consultant anaesthetist half-day rate, £15.66 Band 5 nurse and £12.74 Band 5 ODP hourly-rates. NHS cost of 1-hour theatre utilisation £1,200 and NHS cost of 1-hour outpatient clinic room hire £142. Biopsy time was estimated as 15 minutes/biopsy. RESULTS: 339 underwent LA-TPBs, 257 underwent S-TPBs and 68 underwent GA-TPBs (for specific health reasons). There were no significant differences in complication rates or histology outcomes between the different anaesthetic methods. 9% could not tolerate LA-TPB. The total direct cost of 257 S-TPBs is £214,511.90 and £35,631.16 for 339 LA-TPBs. Converting S-TPBs to LA would result in a direct cost saving of £187,499.49. The potential profitability against the tariff would be £564,180.77 if all (who could tolerate LA-TPBs) were done under LA. CONCLUSIONS: There are no significant differences in outcomes amongst men undergoing TPB under LA, sedation or GA. Men undergoing GA-TPBs underwent this for significant health indications. Offering men LA as the first-line anaesthetic method for TPBs would result in a significant direct cost saving and improve profitability against fixed tariff. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e622-e622 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Uma Walters More articles by this author Martin J Connor More articles by this author Edward J Bass More articles by this author David Eldred-Evans More articles by this author William Maynard More articles by this author Pallab Sarkar More articles by this author Mariana Bertoncelli Tanaka More articles by this author Henry Tam More articles by this author Mathias Winkler More articles by this author Hashim U Ahmed More articles by this author Expand All Advertisement Loading ...