Cost analysis of three anesthetic regimens under auditory evoked potentials monitoring in gynecologic laparoscopic surgery.
BACKGROUND
Cost analyses of different anesthetic techniques have not been investigated in Taiwan. We compared propofol-based total intravenous anesthesia (TIVA), sevoflurane (SEVO) and desflurane (DES) anesthesias for cost and outcome under A-line auditory evoked potentials (AEP) monitoring.


METHODS
We studied 90 consecutive female patients (ASAI-II) scheduled to undergo elective gynecologic laparoscopic surgery. The study was prospective, randomized, and single-blind in design. All patients were randomly divided into 3 groups: i.e. groups TIVA, SEVO and DES. The A-line auditory evoked potential index (AAI) was maintained between 15-25. At the start of skin closure, the applied anesthetic was discontinued, and time of recovery from anesthesia was thenceforth reckoned until spontaneous opening of eyes and extubation. The costs of drugs were counted in New Taiwan (NT) dollars.


RESULTS
The total cost was significantly higher in the SEVO and DES groups than in the TIVA group (NT 1,243, 1028, and 889, respectively) (P < 0.001). In addition, the cost of the principal anesthetic drug was significantly higher in the SEVO than in the DES and TIVA groups (NT 756, 530, and 468, respectively) (P < 0.01). Faster recovery was seen in the TIVA group than in the DES group and SEVO group (8.2, 13.7, 16.2 min, respectively) (P < 0.001). Incidences of postoperative nausea, vomiting, and pain were not significantly different among 3 groups.


CONCLUSIONS
The cost of TIVA with propofol was less than SEVO or DES anesthesia and moreover, propofol TIVA offered benefit of faster recovery in our study.
Horng
Huei-Chi
HC
Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.
Kuo
Chang-Po
CP
Ho
Ching-Chih
CC
Wong
Chih-Shung
CS
Yu
Mu-Hsien
MH
Cherng
Chen-Hwan
CH
Wu
Ching-Tang
CT
D000769:Anesthesia, Inhalation / Q000191:economics*; D000771:Anesthesia, Intravenous / Q000191:economics*; D003365:Costs and Cost Analysis; D000077335:Desflurane; D005072:Evoked Potentials, Auditory / Q000187:drug effects*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000494:pharmacology; D010535:Laparoscopy; D008738:Methyl Ethers / Q000494:pharmacology*; D008991:Monitoring, Physiologic; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D015742:Propofol / Q000494:pharmacology*; D011446:Prospective Studies; D000077149:Sevoflurane; D016037:Single-Blind Method
D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane; D015742:Propofol