Anesthetic maintenance with propofol infusion is less expensive per minute of surgery than sevoflurane or desflurane

ABSTRACT

Cost comparison between three common anesthetic agents. Retrospective analysis. Patients had been randomized to anesthetic maintenance with either desflurane, sevoflurane, or propofol. Operating room in an academic medical center. 103 patients undergoing general endotracheal anesthesia. Patients were ASA class I-III and between 18 and 75 years old. Cardiac, Neurologic, and regional cases were excluded. Volatile anesthetic cost was determined using the following formula Cost = [[concentration][FGF][duration][MW][cost/ml]]/[2412][D]. To determine propofol cost, average infusion rate [mcg/kg/min.], patient weight, and duration were measured. Cost for each agent was then divided by surgical time to compare the results on a cost/min. basis. Per minute of surgery, propofol was the least expensive agent for anesthetic maintenance at $0.12/min. Sevoflurane cost $0.18/min and desflurane cost $0.48/min. The differences between all three agents were statistically significant [p <0.05]. Propofol maintenance was associated with a higher intra-operative fentanyl dose. The average fentanyl dose in the propofol group was 468 meg, sevoflurane was 321 meg, and desflurane was 284 meg. There was no association between intra-operative fentanyl dose and anesthetic maintenance cost per minute of surgery. Surgical time did not significantly differ between the three groups and averaged over three hours. Anesthetic maintenance with propofol may help peri-operative physicians deliver care in the most cost effective manner possible