Patient-Controlled Intravenous Morphine Analgesia Combined with Transcranial Direct Current Stimulation for Post-Thoracotomy Pain: A Cost-Effectiveness Study and A Feasibility for Its Future Implementation

Nemanja Rancic, Katarina Mladenovic, Nela V. Ilic, Viktorija Dragojevic-Simic, Menelaos Karanikolas, Tihomir V. Ilic and Dusica M. Stamenkovic
Additional contact information
Nemanja Rancic: Medical Faculty Military Medical Academy, University of Defense, 11 000 Belgrade, Serbia
Katarina Mladenovic: Medical Faculty Military Medical Academy, University of Defense, 11 000 Belgrade, Serbia
Nela V. Ilic: Medical Faculty, University of Belgrade, 11 000 Belgrade, Serbia
Viktorija Dragojevic-Simic: Medical Faculty Military Medical Academy, University of Defense, 11 000 Belgrade, Serbia
Menelaos Karanikolas: Department of Anesthesiology, Washington University School of Medicine, St Louis, MO 63110, USA
Tihomir V. Ilic: Medical Faculty Military Medical Academy, University of Defense, 11 000 Belgrade, Serbia
Dusica M. Stamenkovic: Medical Faculty Military Medical Academy, University of Defense, 11 000 Belgrade, Serbia

IJERPH, 2020, vol. 17, issue 3, 1-9

Abstract: This prospective randomized study aims to evaluate the feasibility and cost-effectiveness of combining transcranial direct current stimulation (tDCS) with patient controlled intravenous morphine analgesia (PCA-IV) as part of multimodal analgesia after thoracotomy. Patients assigned to the active treatment group (a-tDCS, n = 27) received tDCS over the left primary motor cortex for five days, whereas patients assigned to the control group (sham-tDCS, n = 28) received sham tDCS stimulations. All patients received postoperative PCA-IV morphine. For cost-effectiveness analysis we used data about total amount of PCA-IV morphine and maximum visual analog pain scale with cough (VASP-C max ). Direct costs of hospitalization were assumed as equal for both groups. Cost-effectiveness analysis was performed with the incremental cost-effectiveness ratio (ICER), expressed as the incremental cost (RSD or US$) per incremental gain in mm of VASP-C max reduction. Calculated ICER was 510.87 RSD per VASP-C max 1 mm reduction. Conversion on USA market (USA data 1.325 US$ for 1 mg of morphine) revealed ICER of 189.08 US$ or 18960.39 RSD/1 VASP-C max 1 mm reduction. Cost-effectiveness expressed through ICER showed significant reduction of PCA-IV morphine costs in the tDCS group. Further investigation of tDCS benefits with regards to reduction of postoperative pain treatment costs should also include the long-term benefits of reduced morphine use.

Keywords: morphine; transcranial direct current stimulation; acute pain; pain, postoperative; pharmacoeconomics; cost and cost analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/17/3/816/pdf (application/pdf)
https://www.mdpi.com/1660-4601/17/3/816/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:17:y:2020:i:3:p:816-:d:313852

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().