title: Analysis of the cost-effectiveness of remifentanil-based general anesthesia: a survey of clinical economics under the Japanese health care system.
abstract: OBJECTIVE
  Remifentanil has been available in Japan for 3 years. The use of this new opioid is considered a useful adjuvant to general anesthesia. Knowing the exact cost-effectiveness of remifentanil should lead to improved anesthetic outcomes with a reasonable cost.
  
  
  METHODS
  This single-blinded, prospective, randomized study compared the cost of remifentanil-based general anesthesia combined with isoflurane, sevoflurane, or propofol with fentanyl-based conventional techniques in 210 women who underwent breast surgeries.
  
  
  RESULTS
  Remifentanil-based general anesthesia was no more expensive than fentanyl-based conventional anesthesia. Postoperative nausea and vomiting was significantly less frequent after remifentanil-based than fentanyl-based anesthesia.
  
  
  CONCLUSIONS
  This study shows that remifentanil-based general anesthesia is no more expensive than conventional fentanyl-based anesthesia under the Japanese health care system because of the small difference in price between remifentanil and fentanyl.
authors.affiliation: Department of Health Policy Science, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. tmnakada@yahoo.com.sg
authors.forename: Takeo
authors.initials: T
authors.lastname: Nakada
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ikeda
authors.forename: Miyuki
authors.initials: M
authors.lastname: Yokota
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kawahara
mesh_terms: D000759:Adjuvants, Anesthesia / Q000191:economics; D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000191:economics*; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous / Q000191:economics*; D001794:Blood Pressure / Q000187:drug effects; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics; D005260:Female; D005283:Fentanyl / Q000191:economics; D006801:Humans; D007564:Japan; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009313:National Health Programs; D009609:Nitrous Oxide; D010880:Piperidines / Q000191:economics*; D020250:Postoperative Nausea and Vomiting / Q000191:economics / Q000453:epidemiology; D015742:Propofol; D011446:Prospective Studies; D000077208:Remifentanil; D000077149:Sevoflurane; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D000759:Adjuvants, Anesthesia; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D009609:Nitrous Oxide; D000077208:Remifentanil; D005283:Fentanyl; D015742:Propofol
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