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Canadian Journal of Anesthesia, Vol 46, 1008-1013, Copyright © 1999 by Canadian Anesthesiologists' Society

ARTICLES

Cost comparison of sevoflurane with isoflurane anesthesia in arthroscopic menisectomy surgery

CR Ries, A Azmudeh, LG Franciosi, SK Schwarz and BA MacLeod
Department of Anesthesia, The University of British Columbia, Canada. crries@interchange.ubc.ca

PURPOSE: To determine the "real world" cost of sevoflurane compared with isoflurane in balanced general anesthesia for daycare arthroscopic menisectomy, we prospectively investigated perioperative drug requirement and expense as well as recovery time. METHODS: Following intravenous induction, 40 consenting adult patients randomly received either sevoflurane- or isoflurane-based anesthesia with a standardized gas inflow rate of 3 l x min. Recovery was assessed in the postanesthetic recovery room (PARR) in a double-blind manner at 15 min intervals using the Aldrete scoring system until patients met discharge criteria. RESULTS: Patient demographics, anesthetic duration, volatile potency and adjunct drug requirements were similar in the two groups. Total perioperative drug cost per patient was CAN$38.10+/-10.13 (mean +/- SD) for the sevoflurane group and $23.87+/-6.59 for the isoflurane group (P<0.01). Although the nonvolatile drug cost was comparable between the two groups, the volatile drug cost per patient was $19.40+/-8.80 for sevoflurane and $4.50+/-1.90 for isoflurane (P<0.01). This four-fold sevoflurane-to-isoflurane cost difference was the product of two ratios, both based on the volume of liquid anesthetic: the ratio of consumption, 2.1; and the ratio of institutional price, 2.1. Intraoperative hemodynamic response, time until discharge from the PARR and incidences of postoperative nausea and vomiting did not significantly differ between the two groups. CONCLUSIONS: When used to maintain equipotent balanced general anesthesia for daycare arthroscopic menisectomy, volatile consumption and cost were greater for sevoflurane compared with isoflurane. Nonvolatile perioperative drug cost and recovery times were similar, however, in the two groups.


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 Canadian J. AnesthesiaHome page
S. K. W. Schwarz, N. N. Butterfield, B. A. MacLeod, E. Y. Kim, L. G. Franciosi, and C. R. Ries
Under "real world" conditions, desflurane increases drug cost without speeding discharge after short ambulatory anesthesia compared to isoflurane: [Dans les conditions du <>, le desflurane augmente le cout des medicaments sans hater le depart apres une anesthesie ambulatoire de courte duree compare a l'isoflurane]
Can J Anesth, November 1, 2004; 51(9): 892 - 898.
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