Comparative analysis of costs of total intravenous anaesthesia with propofol and remifentanil vs. balanced anaesthesia with isoflurane and fentanyl

“…The use of short-acting anesthetic drugs, such as remifentanil and propofol can possibly reduce the process times for general anesthesia [21]. In our study, we found differences in the "incision to closure" time as well as in the time to "induction complete".…”

Section: Process Times and Patient Satisfactionmentioning

confidence: 49%

Peripheral nerve blocks give greater hemodynamic stability than general anesthesia for ASA III patients undergoing outpatient knee arthroscopy

et al. 2013

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“…in the last decade, the development of new protocols for balanced anaesthesia has been carried out in human [17,18,21,34,47,50], whereas the last two papers about balanced anaesthesia in swine were from 90 th years [16,56]. effectively, in veterinary practice inhalant anesthetic agents are the preferred method for maintenance of general anaesthesia since they are easy to be administered, the depth of anaesthesia can be rapidly and predictably modulated, and the recovery time is rapid [31].…”

Section: Discussionmentioning

confidence: 99%

A Novel and Effective Balanced Intravenous-Inhalant Anaesthetic Protocol in Swine by Using Unrestricted Drugs

et al. 2014

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Nowadays, because of increasing employment of swine for experimental studies and medical training, it is hopeful to investigate novel and effective anaesthetic protocols for preserving the animal welfare in medical investigation and concurrently improving the quality of research. Therefore, the aim of this study was to investigate a novel and effective anaesthetic protocol in swine undergoing major surgery, by translating know-how of combined anaesthesia from human protocols. Seven landrace swine were anaesthetized for three hours by a combined trial anaesthetic protocol (sedation: medetomidine, acepromazine, atropine and tramadol; induction: propofol, medetomidine and acepromazine; anaesthesia: isofluorane, propofol, medetomidine and acepromazine) and both clinical and haemodynamic parameters were compared with those of five swine anaesthetized with a control protocol (sedation: diazepam, ketamine and atropina; induction: diazepam and ketamine; anaesthesia: isofluorane). Both cardiac frequency (CF) and mean blood pressure (MBP) were significantly (P<0.05) more stable in trial protocol (CF: 78.3 ± 4.6-81.1 ± 5, MBP: 63.9 ± 10.7-96.4 ± 13.0) compared to control protocol (CF: 93.7 ± 5.5-102.5 ± 8.5, MBP: 71.0 ± 6.6-108.7 ± 7.2). The body temperature remained stable in trial protocol (°C: 36.9 ± 0.7-37.2 ± 0.3) compared to control anaesthesia (°C: 36.4 ± 0.3-37.3 ± 0.2, P<0.05). Haematosis improved undergoing combined anaesthesia (+2%, P<0.05) whereas did not change in control animals. There were no differences in respiratory rate between trial and control protocols. This study demonstrates that the proposed balanced intravenous-inhalant protocol permits to carry out a very effective, stable and safe anaesthesia in swine undergoing deep anaesthesia.

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“…B. die Aufwachraumzeit durch die Verwendung teurer, aber kurz wirksamer Substanzen deutlich verkürzt werden. Epple et al [12] konnten nachweisen, dass die Verwendung von Propofol und Remifentanil kosteneffektiver ist als eine Narkose mit Isofluran und Fentanyl, da die Aufwachzeit verkürzt wird und so die Gesamtkosten verringert werden.…”

Section: Diskussionunclassified

Preislisten am anästhesiologischen Arbeitsplatz

Snyder-Ramos

Bauer²,

Martín

et al. 2003

Der Anaesthesist

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The imminent introduction of the DRG (diagnosis-related-group) system is putting hospitals in Germany under considerable pressure. This requires that personnel are efficiently allocated by optimizing organizational procedures and that the limited resources be distributed in a cost-effective manner. One prerequisite for this is a marked cost-consciousness on the part of those who "incur costs" in providing a service. To increase the awareness of costs in clinical physicians, the cost structures must be transparent. In order to achieve this goal, a project was initiated at the Department of Anaesthesiology at the University Hospital of Heidelberg, which aimed to enhance the cost-consciousness of the staff by making price lists available to anaesthesiologists at the workplace. In addition to the price lists, the 25 most expensive medications and medical products were added as an ABC analysis. The departmental staff was interviewed by questionnaire as to whether this project was reasonable. After 1 year the interview was repeated. The results of the questionnaire showed that in the opinion of the staff, price lists are an effective tool, as cost-consciousness on the part of clinical physicians can be enhanced by making price structures transparent. This is a major prerequisite for individual motivation in the cost-effective management. Although the ABC analyses demonstrate no long-term effect of the price-transparency on the cost structures, the staff showed increased cost-consciousness and individual motivation for economic tasks.

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Comparative analysis of costs of total intravenous anaesthesia with propofol and remifentanil vs. balanced anaesthesia with isoflurane and fentanyl

Abstract: We conclude that propofol and remifentanil is more cost-effective than isoflurane/fentanyl due to its better recovery profile, reduced total direct costs and higher patient satisfaction.

Cited by 29 publications

References 47 publications

Peripheral nerve blocks give greater hemodynamic stability than general anesthesia for ASA III patients undergoing outpatient knee arthroscopy

Peripheral nerve blocks give greater hemodynamic stability than general anesthesia for ASA III patients undergoing outpatient knee arthroscopy

A Novel and Effective Balanced Intravenous-Inhalant Anaesthetic Protocol in Swine by Using Unrestricted Drugs

Preislisten am anästhesiologischen Arbeitsplatz

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