title: Target-controlled inhalation anaesthesia: A cost-benefit analysis based on the cost per minute of anaesthesia by inhalation.
abstract: BACKGROUND
  End-tidal target-controlled inhalational anaesthesia (TCIA) with halogenated agents (HA) provides a faster and more accurately titrated anaesthesia as compared to manually-controlled anaesthesia. This study aimed to measure the macro-economic cost-benefit ratio of TCIA as compared to manually-controlled anaesthesia.
  
  
  METHODS
  This retrospective and descriptive study compared direct drug spending between two hospitals before 2011 and then after the replacement of three of six anaesthesia machines with TCIA mode machines in 2012 (Aisys carestation®, GE). The direct costs were obtained from the pharmacy department and the number and duration of the anaesthesia procedures from the computerized files of the hospital.
  
  
  RESULTS
  The cost of halogenated agents was reduced in the hospital equipped with an Aisys carestation®by 13% as was the cost of one minute of anaesthesia by inhalation (€0.138 and €0.121/min between 2011 and 2012). The extra cost of the implementation of the 3 anaesthesia machines could be paid off with the resulting savings over 6 years.
  
  
  CONCLUSIONS
  TCIA appears to have a favourable cost-benefit ratio. Despite a number of factors, which would tend to minimise the saving and increase costs, we still managed to observe a 13% savings. Shorter duration of surgery, type of induction as well as the way HA concentration is targeted may influence the savings results obtained.
authors.affiliation: CHU Limoges, Hôpital Dupuytren, Anesthésie Réanimation, 2, avenue Martin-Luther-King, 87042 Limoges, France. Electronic address: sponsonnard@gmail.com.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Ponsonnard
authors.affiliation: CHU Limoges, Hôpital Dupuytren, Anesthésie Réanimation, 2, avenue Martin-Luther-King, 87042 Limoges, France. Electronic address: agaly@hotmail.fr.
authors.forename: Antoine
authors.initials: A
authors.lastname: Galy
authors.affiliation: CHU Limoges, Hôpital Dupuytren, Anesthésie Réanimation, 2, avenue Martin-Luther-King, 87042 Limoges, France. Electronic address: jeromemcros@yahoo.fr.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Cros
authors.affiliation: CHU Limoges, Hôpital Dupuytren, Anesthésie Réanimation, 2, avenue Martin-Luther-King, 87042 Limoges, France. Electronic address: armelle.marie-daragon@chu-limoges.fr.
authors.forename: Armelle Marie
authors.initials: AM
authors.lastname: Daragon
authors.affiliation: CHU Limoges, Hôpital Dupuytren, Anesthésie Réanimation, 2, avenue Martin-Luther-King, 87042 Limoges, France; Université Limoges, Faculté de médecine, 87000 Limoges, France. Electronic address: nathan@unilim.fr.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Nathan
mesh_terms: D000768:Anesthesia, General / Q000191:economics / Q000295:instrumentation / Q000379:methods; D000769:Anesthesia, Inhalation / Q000191:economics* / Q000295:instrumentation / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000191:economics; D017610:Calcium Compounds / Q000191:economics; D003362:Cost-Benefit Analysis; D006801:Humans; D010087:Oxides / Q000191:economics; D012189:Retrospective Studies; D012972:Sodium Hydroxide / Q000191:economics
chemical_list: D018685:Anesthetics, Inhalation; D017610:Calcium Compounds; D010087:Oxides; C004569:soda lime; D012972:Sodium Hydroxide
keywords: Economic analysis; Halogenated agent; Target-controlled inhalational anaesthesia