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Prospective, randomized cost analysis of anesthesia with remifentanil combined with propofol, desflurane or sevoflurane for otorhinolaryngeal surgery
Author(s) -
Loop T.,
Priebe H.J.
Publication year - 2002
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.2002.461013.x
Subject(s) - medicine , desflurane , remifentanil , alfentanil , anesthesia , anesthetic , isoflurane , sevoflurane , propofol , randomized controlled trial , surgery
Background: In the era of cost containment, cost analysis should demonstrate the cost‐effectiveness of new anesthetic drugs. Methods: This single‐blind, prospective, randomized study compared the costs of three remifentanil (REM)‐based anesthetic techniques with a conventional one in 120 patients undergoing otorhinolaryngeal surgery. The patients were randomized (n=30 each group) to either receive a combination of REM with propofol, desflurane or sevoflurane, or a conventional anesthetic with thiopentone, alfentanil, isoflurane and N 2 O. Results: The costs for anesthetic and nonanesthetic drugs and for disposables were twice as high in the three REM‐based groups as in the conventional group (REM/PRO 0.51 €/min, REM/DES 0.42 €/min, and REM/SEVO 0.41 €/min vs. 0.18 €/min in the ALF/ISO/N 2 O group; P <0.05). Wastage of intravenous drugs accounted for up to 40% of total costs. In all REM groups, early recovery was predictably faster and more complete ( P< 0.05). Patient satisfaction was equally high (90–97%) in all groups, with less nausea in the REM/PRO group. Conclusion: This study demonstrates that REM‐based anesthetic techniques are more expensive than a conventional technique using alfentanil, isoflurane and N 2 O. This is the result of higher costs of anesthetic and nonanesthetic drugs and of disposables. The wastage of intravenous drugs contributes considerably to these costs.