title: Comparative cost-analysis of a propofol-cisatracurium-based anesthesia with remifentanil or fentanyl for laparoscopic surgery.
abstract: To compare the intraoperative costs of intravenous propofol-based anesthesia for laparoscopic cholecystectomy, a total of 42 patients were randomly assigned to receive remifentanil or fentanyl as adjuvant using the bispectral index anesthesia monitoring. The average anesthesia calculated costs per hour (and per minute) were 79.45 (1.32) in the fentanyl group and 65.36 (1.09) in the remifentanil group. The calculated mean cost per patient was 76.56 in the fentanyl group and 58.86 in the remifentanil group. In conclusion, for propofol-cisatracurium-based anesthesia for laparoscopic surgery, when applying the bispectral index to guide the administration of hypnotic anesthetic drugs and ensure an adequate and stable depth of anesthesia, the cost of anesthesia is lower using remifentanil as an adjuvant rather than fentanyl. The clinical relevance is that it could be the intravenous anesthesia technique of choice in laparoscopic surgery for cholecystectomy from a cost-minimization standpoint.
authors.affiliation: University of Messina, Department of Neuroscience Psychiatric and Anesthesiological Sciences, Policlinico Universitario G. Martino, Messina, Italy. vfodale@unime.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Fodale
authors.forename: Caterina
authors.initials: C
authors.lastname: Praticó
authors.forename: Marco
authors.initials: M
authors.lastname: Tescione
authors.forename: Tullio
authors.initials: T
authors.lastname: Lucanto
authors.forename: Salvatore
authors.initials: S
authors.lastname: Tanania
authors.forename: Letterio B
authors.initials: LB
authors.lastname: Santamaria
mesh_terms: D000759:Adjuvants, Anesthesia / Q000191:economics*; D018686:Anesthetics, Intravenous / Q000191:economics*; D001279:Atracurium / Q000031:analogs & derivatives* / Q000191:economics; D017081:Cholecystectomy, Laparoscopic / Q000191:economics*; D003365:Costs and Cost Analysis; D005260:Female; D005283:Fentanyl / Q000191:economics*; D006801:Humans; D007430:Intraoperative Care / Q000191:economics*; D007558:Italy; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000191:economics*; D015742:Propofol / Q000191:economics*; D011446:Prospective Studies; D000077208:Remifentanil
chemical_list: D000759:Adjuvants, Anesthesia; D018686:Anesthetics, Intravenous; D010880:Piperidines; D001279:Atracurium; D000077208:Remifentanil; C101584:cisatracurium; D005283:Fentanyl; D015742:Propofol