Pharmacoeconomics of propofol versus thiopental for induction of anaesthesia in short procedures.
This study compared the costs and benefits of using propofol/fentanyl versus thiopental/fentanyl for induction of anaesthesia in short procedures. A prospective, cohort trial was conducted in conjunction with a patient survey. The study population included a consecutive sample of American Society of Anaesthesiologists. Class I or II patients who underwent short operative procedures and who were given one of the studied anaesthetic regimens. Insoflurane/N2O was used for maintenance of anaesthesia in all cases. Propofol patients showed a significantly shorter time to eye opening (p = 0.0025); orientation to date of birth, place, and day of week (p = 0.0002); time to consciousness (p = 0.0019); and time in recovery room (p = 0.013); but not time to tolerating 50 mL of oral fluid (p = 0.06). Nausea and vomiting occurred in 41% of thiopental patients and 19% of propofol patients (difference 22%; 95% C.I., -1% to 44%). Based on survey results, propofol patients subjectively reported fewer side effects upon returning home and were able to resume daily activities earlier than thiopental patients. With the current staffing and patient load at our institution, an estimated 4.8 hours of nursing time per day would be made available if propofol were used in place of thiopental for induction of anaesthesia in these procedures. If propofol were used for all daycare surgery patients in our institution, the annual acquisition cost is projected to be $60,331.28 versus $8,079.68 for thiopental.(ABSTRACT TRUNCATED AT 250 WORDS)
Hsu
S H
SH
Vancouver Hospital and Health Sciences Centre, British Columbia, Canada.
Shalansky
S J
SJ
D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000191:economics* / Q000379:methods; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000191:economics*; D001955:British Columbia; D015331:Cohort Studies; D016527:Drug Costs; D005260:Female; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000009:adverse effects / Q000191:economics* / Q000592:standards; D011446:Prospective Studies; D013874:Thiopental / Q000009:adverse effects / Q000191:economics* / Q000592:standards