This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Nitrous oxide (N2O) is much cheaper than recently introduced volatile anesthetics such as sevoflurane and desflurane, and can reduce the consumption of these anesthetics. The use of N2O is under current debate. The purpose of this study was to evaluate economic effect of 50% N2O during sevoflurane anesthesia in Korea. Methods: Seventy patients were randomly allocated to Group A or Group N. Anesthesia induction was performed using propofol, rocuronium, and 3-5% of sevoflurane with air (Group A) or 50% N2O (Group N). Fresh gas flow (FGF) was 6 L/min during induction, and 3 L/min for maintenance. Mean arterial pressure (MAP), heart rate (HR), bispectral index (BIS), and minimum alveolar concentration (MAC) were recorded. The consumption of sevoflurane was measured at every 10 minutes for the first 1 hour. The economic effect was analyzed based on the payment criterion of Korean National Health Insurance Service. Results: MAP, HR, BIS, and MAC showed no differences between the two groups. The sevoflurane consumptions for the first 1 hour were 39.2 ± 6.3 ml in Group A and 29.2 ± 4.9 ml in Group N (P < 0.01); and the N2O consumption was 93.7 ± 1.5 L in Group N. The total costs of inhaled anesthetics were 16,190 (14.8
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