Use of a remifentanil and propofol combination in outpatients to facilitate rapid discharge home.
The goal of our study was to evaluate whether the combination of remifentanil and propofol facilitated shorter recovery time and decreased charges compared with conventional balanced anesthesia. We studied 49 patients, aged 13 to 75 years, who underwent elective outpatient surgery. All data were analyzed using the Pearson chi2 and the Student t test; results were considered statistically significant at a P value of.05 or less. Group 1 received a remifentanil-propofol combination and group 2, a conventional balanced anesthetic. Group 1 had decreased mean operating room (dollar 280.83 vs dollar 337.42; P = .05) and operating room plus postanesthesia care unit (PACU) (dollar 442.67 vs dollar 544.62) charges (P = .02). Group 1 had less PACU time (48.26 vs 59.62 minutes) and 2 group 1 patients bypassed the PACU. We conclude that a remifentanil-propofol combination is more cost effective than conventional balanced anesthetics and enables some patients to bypass the PACU, resulting in quicker discharge. Our findings have important implications for ambulatory surgery centers and office-based practices.
Brady
William J
WJ
Memorial Medical Center, Johnstown, PA, USA.
Meenan
Daniel R
DR
Shankar
Tirunellai R
TR
Balon
Jennifer A
JA
Mennett
Deanna R
DR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics; D000762:Anesthesia Recovery Period; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D004338:Drug Combinations; D016527:Drug Costs; D017558:Elective Surgical Procedures; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms / Q000191:economics; D010351:Patient Discharge; D010880:Piperidines / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D015742:Propofol / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D011997:Recovery Room / Q000191:economics; D000077208:Remifentanil; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D018686:Anesthetics, Intravenous; D004338:Drug Combinations; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol