Comparative analysis of costs of total intravenous anaesthesia with propofol and remifentanil vs. balanced anaesthesia with isoflurane and fentanyl.
OBJECTIVE
We evaluated the costs and benefits of total intravenous anaesthesia compared with a balanced anaesthesia regimen.


METHODS
One-hundred and twenty-four patients undergoing cataract surgery were randomized to either a propofol/remifentanil or an isoflurane/fentanyl group. In the propofol/remifentanil group, both drugs were used for induction and maintenance of anaesthesia; in the isoflurane/fentanyl group, anaesthesia was induced with etomidate and fentanyl and maintained with isoflurane and fentanyl. All patients received mivacurium for muscle relaxation and the lungs were ventilated mechanically. The use of propofol and remifentanil resulted in a faster emergence and an overall savings per case of [symbol: see text] 12.25 due to a reduction in personnel costs which outweighs the higher drug acquisition costs.


RESULTS
In the propofol and remifentanil group, more patients were satisfied and would accept the same anaesthetic again.


CONCLUSIONS
We conclude that propofol and remifentanil is more cost-effective than isoflurane/fentanyl due to its better recovery profile, reduced total direct costs and higher patient satisfaction.
Department of Anaesthesiology, University of Heidelberg, Heidelberg, Germany.
J
J
Epple
J
J
Kubitz
H
H
Schmidt
J
J
Motsch
B W
BW
Böttiger
E
E
Martin
A
A
Bach
D000759:Adjuvants, Anesthesia / Q000191:economics*; D000368:Aged; D000771:Anesthesia, Intravenous / Q000191:economics*; D018685:Anesthetics, Inhalation / Q000191:economics*; D018686:Anesthetics, Intravenous / Q000191:economics*; D001071:Appointments and Schedules; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D005260:Female; D005283:Fentanyl / Q000191:economics*; D006801:Humans; D007530:Isoflurane / Q000191:economics*; D008297:Male; D009873:Operating Rooms / Q000458:organization & administration; D017060:Patient Satisfaction; D010880:Piperidines / Q000191:economics*; D011184:Postoperative Period; D015742:Propofol / Q000191:economics*; D011446:Prospective Studies; D000077208:Remifentanil; D012121:Respiration, Artificial
D000759:Adjuvants, Anesthesia; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D010880:Piperidines; D007530:Isoflurane; D000077208:Remifentanil; D005283:Fentanyl; D015742:Propofol