Nurse Anesthesia DNP Project Presentations
A Comparative Cost Analysis of Sugammadex and Neostigmine for Elective Robotic Surgery
Academic Level at Time of Presentation
Graduate
Major
DNP
List all Project Mentors & Advisor(s)
Amy Cook
Presentation Format
Poster Presentation
Abstract/Description
Background
Patients undergoing robotic assisted laparoscopic procedures (RALP) are given a neuromuscular blocker for safety during the entirety of the procedure. There are currently tow methods to reverse neuromuscular blockade in patients undergoing RALP. Neostigmine with glycopyrrolate or Sugammadex. Without reversal patients can have residual muscle weakness which prevents them from maintaining their airway following extubation and can lead to significant post-operative morbidity and mortality.
Objective
This retrospective study looked at the comparative cost analysis between sugammadex and the combination of neostigmine and glycopyrrolate for neuromuscular blockade reversal in patients undergoing an elective robotic assisted laparoscopic procedure (RALP).
Method
Data from 313 patients over a year long period was analyzed and data collected on OR and PACU discharge times following administration of neuromuscular blockade reversal to determine if there was a statistically significant difference in the time of OR and PACU discharge for the two reversal groups.
Results
The study found that there was no significant difference between the time of drug administration to PACU and OR discharge, which indicates no significant savings on OR and PACU time. The average cost of administration of sugammadex per patient was found to be around $40 more per patient than the average cost of administration of neostigmine and glycopyrrolate.
Conclusion
While many hospitals across the country are able to implement this method of neuromuscular blocker reversal, some smaller hospital’s do not have the extra wiggle room in their budgets for a projected increase in drug costs for laparoscopic surgeries when many insurance companies and Medicare pay a fixed rate per procedure. While the efficacy of sugammadex for reversal of neuromuscular blockade is superior to that of neostigmine and glycopyrrolate, hospitals will need to recoup some benefit from payers in order to continue to offer this as a treatment due to the significant increase in price to treat comparatively.
Key Words: Sugammadex, neostigmine, neuromuscular blocker reversal, robotic assisted laparoscopic procedure,
Spring Scholars Week 2024 Event
Nurse Anesthesia DNP Project Presentations (NUR 915)
A Comparative Cost Analysis of Sugammadex and Neostigmine for Elective Robotic Surgery
Background
Patients undergoing robotic assisted laparoscopic procedures (RALP) are given a neuromuscular blocker for safety during the entirety of the procedure. There are currently tow methods to reverse neuromuscular blockade in patients undergoing RALP. Neostigmine with glycopyrrolate or Sugammadex. Without reversal patients can have residual muscle weakness which prevents them from maintaining their airway following extubation and can lead to significant post-operative morbidity and mortality.
Objective
This retrospective study looked at the comparative cost analysis between sugammadex and the combination of neostigmine and glycopyrrolate for neuromuscular blockade reversal in patients undergoing an elective robotic assisted laparoscopic procedure (RALP).
Method
Data from 313 patients over a year long period was analyzed and data collected on OR and PACU discharge times following administration of neuromuscular blockade reversal to determine if there was a statistically significant difference in the time of OR and PACU discharge for the two reversal groups.
Results
The study found that there was no significant difference between the time of drug administration to PACU and OR discharge, which indicates no significant savings on OR and PACU time. The average cost of administration of sugammadex per patient was found to be around $40 more per patient than the average cost of administration of neostigmine and glycopyrrolate.
Conclusion
While many hospitals across the country are able to implement this method of neuromuscular blocker reversal, some smaller hospital’s do not have the extra wiggle room in their budgets for a projected increase in drug costs for laparoscopic surgeries when many insurance companies and Medicare pay a fixed rate per procedure. While the efficacy of sugammadex for reversal of neuromuscular blockade is superior to that of neostigmine and glycopyrrolate, hospitals will need to recoup some benefit from payers in order to continue to offer this as a treatment due to the significant increase in price to treat comparatively.
Key Words: Sugammadex, neostigmine, neuromuscular blocker reversal, robotic assisted laparoscopic procedure,