Cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring: a prospective, randomized controlled trial
Abstract Background We compared cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring, in the clinical setting of ear-nose-throat surgery. Methods One hundred twenty adult patients were randomized to four groups. In groups SEVO and SEVO+ anes...
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BMC
2018-07-01
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| Series: | BMC Anesthesiology |
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| Online Access: | http://link.springer.com/article/10.1186/s12871-018-0563-z |
| _version_ | 1818336997074272256 |
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| author | Timea Bocskai Csaba Loibl Zoltan Vamos Gabor Woth Tihamer Molnar Lajos Bogar Laszlo Lujber |
| author_facet | Timea Bocskai Csaba Loibl Zoltan Vamos Gabor Woth Tihamer Molnar Lajos Bogar Laszlo Lujber |
| author_sort | Timea Bocskai |
| collection | DOAJ |
| description | Abstract Background We compared cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring, in the clinical setting of ear-nose-throat surgery. Methods One hundred twenty adult patients were randomized to four groups. In groups SEVO and SEVO+ anesthesia was maintained with sevoflurane, in group SEVO+ with additional bispectral index (BIS) and train-of-four (TOF) monitoring. In groups PROP and PROP+ anesthesia was maintained with propofol, in group PROP+ with additional BIS and TOF monitoring. Results Total cost of anesthesia per hour was greater in group SEVO+ compared to SEVO [€ 19.95(8.53) vs. 12.15(5.32), p < 0.001], and in group PROP+ compared to PROP (€ 22.11(8.08) vs. 13.23(4.23), p < 0.001]. Time to extubation was shorter in group SEVO+ compared to SEVO [11.1(4.7) vs. 14.5(3.9) min, p = 0.002], and in PROP+ compared to PROP [12.6(5.4) vs. 15.2(4.7) min, p < 0.001]. Postoperatively, arterial blood pressure returned to its initial values sooner in groups SEVO+ and PROP+. Conclusions Our study demonstrated that the use of BIS and TOF monitoring decreased the total cost of anesthesia drugs and hastened postoperative recovery. However, in our circumstances, these were associated with higher disposables costs. Detailed cost analysis and further investigations are needed to identify patient populations who would benefit most from additional monitoring. Trial registration ClinicalTrials.gov, NCT02920749. Retrospectively registered (date of registration September 2016). |
| first_indexed | 2024-12-13T14:48:12Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-13T14:48:12Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-88e4524f91bb44f7bbf40e52bd4188012022-12-21T23:41:25ZengBMCBMC Anesthesiology1471-22532018-07-011811810.1186/s12871-018-0563-zCost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring: a prospective, randomized controlled trialTimea Bocskai0Csaba Loibl1Zoltan Vamos2Gabor Woth3Tihamer Molnar4Lajos Bogar5Laszlo Lujber6Department of Anaesthesiology and Intensive Therapy, University of Pécs, Medical SchoolDepartment of Anaesthesiology and Intensive Therapy, University of Pécs, Medical SchoolDepartment of Anaesthesiology and Intensive Therapy, University of Pécs, Medical SchoolDepartment of Anaesthesiology and Intensive Therapy, University of Pécs, Medical SchoolDepartment of Anaesthesiology and Intensive Therapy, University of Pécs, Medical SchoolDepartment of Anaesthesiology and Intensive Therapy, University of Pécs, Medical SchoolDepartment of Otorhinolaryngology, University of Pécs, Medical SchoolAbstract Background We compared cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring, in the clinical setting of ear-nose-throat surgery. Methods One hundred twenty adult patients were randomized to four groups. In groups SEVO and SEVO+ anesthesia was maintained with sevoflurane, in group SEVO+ with additional bispectral index (BIS) and train-of-four (TOF) monitoring. In groups PROP and PROP+ anesthesia was maintained with propofol, in group PROP+ with additional BIS and TOF monitoring. Results Total cost of anesthesia per hour was greater in group SEVO+ compared to SEVO [€ 19.95(8.53) vs. 12.15(5.32), p < 0.001], and in group PROP+ compared to PROP (€ 22.11(8.08) vs. 13.23(4.23), p < 0.001]. Time to extubation was shorter in group SEVO+ compared to SEVO [11.1(4.7) vs. 14.5(3.9) min, p = 0.002], and in PROP+ compared to PROP [12.6(5.4) vs. 15.2(4.7) min, p < 0.001]. Postoperatively, arterial blood pressure returned to its initial values sooner in groups SEVO+ and PROP+. Conclusions Our study demonstrated that the use of BIS and TOF monitoring decreased the total cost of anesthesia drugs and hastened postoperative recovery. However, in our circumstances, these were associated with higher disposables costs. Detailed cost analysis and further investigations are needed to identify patient populations who would benefit most from additional monitoring. Trial registration ClinicalTrials.gov, NCT02920749. Retrospectively registered (date of registration September 2016).http://link.springer.com/article/10.1186/s12871-018-0563-zAnesthesiaPatient safetyCostBispectral indexTrain-of-four |
| spellingShingle | Timea Bocskai Csaba Loibl Zoltan Vamos Gabor Woth Tihamer Molnar Lajos Bogar Laszlo Lujber Cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring: a prospective, randomized controlled trial BMC Anesthesiology Anesthesia Patient safety Cost Bispectral index Train-of-four |
| title | Cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring: a prospective, randomized controlled trial |
| title_full | Cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring: a prospective, randomized controlled trial |
| title_fullStr | Cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring: a prospective, randomized controlled trial |
| title_full_unstemmed | Cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring: a prospective, randomized controlled trial |
| title_short | Cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring: a prospective, randomized controlled trial |
| title_sort | cost effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring a prospective randomized controlled trial |
| topic | Anesthesia Patient safety Cost Bispectral index Train-of-four |
| url | http://link.springer.com/article/10.1186/s12871-018-0563-z |
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