• Lourdes Ferreira Laso, Amanda López Picado, Fernando Antoñanzas Villar, Laura Lamata de la Orden, Mar Ceballos Garcia, Carolina Ibañez López, Lorena Pipaon Ruilope, Felix Lamata Hernandez, Cesar Valero Martinez, Felipe Aizpuru, and Roberto Hernandez Chaves.
• Department of Anesthesiology and Postoperative Care, San Peter Hospital, Logroño, Spain, mlferreiralaso@gmail.com.
• Clin Drug Investig. 2015 Sep 1; 35 (9): 575-82.

Background And ObjectiveEffective 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.MethodsA 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.ResultsConsidering 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.ConclusionInfiltration 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 Registrationclinicaltrials.gov: reference number NCT01389934. http://clinicaltrials.gov/show/NCT01389934

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