Background Early recovery is a concept involving the entire medical team following caesarean section. Carbetocin (Pabal) is currently indicated for prevention of uterine atony after delivery by caesarean section. Administration of carbetocin requires a single dose after caesarean section; this allows the removal of an intravenous drip on exit from the operating room and contributes to the early recovery of patient’s autonomy.
Purpose The objective of this study was to evaluate the use of carbetocin in caesarean section.
Material and methods We compared the medical records from January 2015 where oxytocin (Syntocinon) was used for the prevention of uterine atony until March 2016 after the introduction of carbetocin in April 2015. Simultaneously with this comparison, a satisfaction questionnaire was distributed to patients who received carbetocin.
Results 71 women gave birth by caesarean section: 33 in January 2015 and 38 in March 2016. Average length of post-caesarean recovery was 7.6 days for January and 6.7 days for March (a difference of 0.9 days). The French costs for hospital stays according to the diagnosis related group (DRG) for uncomplicated caesarean section and the national length of stay for this DRG allowed us to assess the cost of a hospital day for an uncomplicated caesarean section as €667.17. The reduction of 0.9 days per stay allows a saving of €609 per stay. The average costs of administration are €25.27/per stay for carbetocin and €5.41/per stay for oxytocin, a difference of €19.86. 50% of patients were very satisfied with their recovery of autonomy, 27% somewhat satisfied and 23% dissatisfied because of pain. Of the 26 patients, 7 had a previous caesarean delivery without an early recovery protocol and 86% gave preference to the new protocol.
Conclusion Early recovery after caesarean section has enabled savings in the cost of stay of €609.45. However, these savings cannot be exclusively attributed to the use of carbetocin. Indeed, many other parameters influence the decrease in length of stay. Carbetocin is more expensive than oxytocin but its use allows a clear improvement in patients’ comfort.
References and/or acknowledgements Laboratory data http://www.atih.sante.fr
No conflict of interest
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