Global Advanced Research Journal of Medicine and Medical Sciences (GARJMMS) ISSN: 2315-5159
June 2017 Vol. 6(6), pp. 111-115
Copyright © 2017 Global Advanced Research Journals
Full Length Research Paper
Comparison of the cost-effectiveness of Propofol intravenous anesthesia and Isoflurane inhalation anesthesia: a randomized clinical Trial
Javad Nourian1, Fatemeh Mehravar2 and Mohammad Bagher Sohrabi3*
1Department of Anaesthesiology, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.
2MSc of Epidemiology, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.
3General Practitioner, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
*Corresponding Author E-mail: email@example.com; Tel: +982332395054; Fax: +982332394800
Accepted 19 June, 2017
In the recent years, managed care plans have been presented and physicians and health care centers focused on cost-effectiveness of medical procedures. The purpose of this study was comparison of the cost-effectiveness of intravenous Propofol anesthesia versus inhalational Isoflurane anesthesia for maintenance of anesthesia. In this randomized, single-blind, parallel clinical trial, 104 eligible consecutive surgical patients were selected in Imam Hossein hospital of Shahroud and randomly placed into two groups after justification and obtaining informed consent. In intervention group Anesthesia continued with Propofol and Fentanyl and in control group it continued with Isoflurane and Fentanyl. Anesthesia depth monitoring was performed in all patients and Bispectral Index (BIS) was kept between 45 and 60. The outcome measures include systolic blood pressure, heart rate, sweating and pupil size during anesthesia also recovery complications and recovery duration. Price of the used anesthetic for each patient was calculated. In Propofol group were lower nausea and vomiting, after operation and also the average recovery time was significantly lower in Propofol group (p = 0.0001). Other variables such as the cost of anesthesia had not significant difference and were similar in both groups. Induction with Propofol with Bispectral Index control for maintenance of anesthesia is more effective than Isoflurane. Propofol causes less postoperative nausea and vomiting, shorter recovery time, no environmental pollution and it does not impose additional cost to the patient and the hospital.
Keywords: Anesthesia, Isoflurane, Propofol, Cost-effectiveness
Auerswald K, Behrends K, Burkhardt U, Olthoff D (2015). (Propofol for pediatric patients in ear, nose and throat surgery. Practicability, quality and cost-effectiveness of different anaesthesia procedures for adenoidectomy in infants). Anaesthesist. 55(8):846-53. (German).
Boldt J, Müller M, Uphus D, Hempelmann G (2014). Cost aspects in anesthesia. Propofol versus isoflurane anesthesia. Anaesthesist. 45(8):731-736. (German).
Camci E, Koltka K, Celenk Y, Tugrul M, Pembeci K (2014). Bispectral index-guided desflurane and propofol anesthesia in ambulatory arthroscopy: comparison of recovery and discharge profiles. J. Anesth. 20(2):149-152.
Dexter F, Bayman EO and Epstein RH (2013). Statistical modeling of average and variability of time to extubation for meta-analysis comparing desflurane to sevoflurane. Anesth. Analg. 110: 570-580.
Dolk A, Cannerfelt R, Anderson RE, Jakobsson J (2013). Inhalation anaesthesia is cost-effective for ambulatory surgery: a clinical comparison with propofol during elective knee arthroscopy. Eur. J. Anaesthesiol. 19(2):88-92.
Eger EI, White PF, Bogetz MS (2014). Clinical and economic factors important to anaesthetic choice for day-case surgery. Pharmacoeconomics. 17(3):245-262.
Engoren, MC, Kraras C, Garzia F (2011). Propofol-based versus fentanyl-isoflurane—Based anesthesia for cardiac surgery. J. cardiothoracic and vascular anesth. 12(2): 177-181.
Epple J, Kubitz J, Schmidt H, Motsch J, Bottiger BW, Martin E, et al (2013). Comparative analysis of costs of total intravenous anaesthesia with propofol and remifentanil vs. balanced anaesthesia with isoflurane and fentanyl. Eur. J. Anaesthesiol. 18(1):20-28.
Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA, et al (2014). Consensus guidelines for the management of postoperative nausea and vomiting. Anesth. Analg. 118: 85-113.
Greenhalgh T (2014). Integrating Mental Health in Primary Care: A Global Perspective. London J. Primary Care. 2(1):81-2.
Heidvall M, Hein A, Davidson S, Jakobsson J (2012). Cost comparison between three different general anaesthetic techniques for elective arthroscopy of the knee. Acta Anaesthesiol. Scand. 44(2):157-162.
Loop T, Priebe HJ (2012). Prospective, randomized cost analysis of anesthesia with remifentanil combined with propofol, desflurane or sevoflurane for otorhinolaryngeal surgery. Acta Anaesthesiol. Scand. 46(10):1251-1260.
Ortiz J CL, Tolpin DA, Minard CG, Scott BG, River JM (2014). Randomized, controlled trial comparing the effects of anesthesia with propofol, isoflurane, desflurane and sevoflurane on pain after laparoscopic cholecystectomy. Revista Brasileira de Anestesiologia. 63(4):145-151.
Ozkose Z, Ercan B, Unal Y, Yardim S, Kaymaz M, Dogulu F, et al (2011). Inhalation versus total intravenous anesthesia for lumbar disc herniation: comparison of hemodynamic effects, recovery characteristics, and cost. J. Neurosurg. Anesthesiol. 13(4):296-302.
Sloan FA, Picone GA, DHT J, Chou SY (2011). Hospital ownership and cost and quality of care: is there a dime’s worth of difference? J. health economics. 20(1):1-21.
Smith I (2013). Inhalation versus intravenous anesthesia for day surgery. Ambulatory Surgery. 10(2): 89-94.
Struys MM, Somers AA, Van Den Eynde N, Herregods LL, Dyzers D, Robays HM, et al (2012). Cost-reduction analysis of propofol versus sevoflurane: maintenance of anaesthesia for gynaecological surgery using the bispectral index. Eur. J. Anaesthesiol. 19(10):727-734.
Visser K, Hassink EA, Bonsel GJ, Moen J, Kalkman CJ (2011). Randomized controlled trial of total intravenous anesthesia with propofol versus inhalation anesthesia with isoflurane-nitrous oxide: postoperative nausea with vomiting and economic analysis. Anesthesiol. 95(3):616-626.
White PF, Tang J, Wender RH, Yumul R, Stokes OJ, Sloninsky A, et al (2011). Desflurane versus sevoflurane for maintenance of outpatient anesthesia: the effect on early versus late recovery and perioperative coughing. Anesth. Analg. 109(2):387-93.
- Javad Nourian on Google Scholar
- Javad Nourian on Pubmed
- Fatemeh Mehravar on Google Scholar
- Fatemeh Mehravar on Pubmed
- Mohammad Bagher Sohrabi on Google Scholar
- Mohammad Bagher Sohrabi on Pubmed