title: Cost comparison of sevoflurane with isoflurane anesthesia in arthroscopic menisectomy surgery.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Anesthesia, The University of British Columbia, Canada. crries@interchange.ubc.ca
authors.forename: C R
authors.initials: CR
authors.lastname: Ries
authors.forename: A
authors.initials: A
authors.lastname: Azmudéh
authors.forename: L G
authors.initials: LG
authors.lastname: Franciosi
authors.forename: S K
authors.initials: SK
authors.lastname: Schwarz
authors.forename: B A
authors.initials: BA
authors.lastname: MacLeod
mesh_terms: D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation / Q000191:economics*; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D001182:Arthroscopy / Q000191:economics*; D003365:Costs and Cost Analysis; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000494:pharmacology*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008738:Methyl Ethers / Q000494:pharmacology*; D008875:Middle Aged; D011446:Prospective Studies; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D007530:Isoflurane