Low‐flow isoflurane‐nitrous oxide anaesthesia offers substantial economic advantages over high‐and medium‐flow isoflurane‐nitrous oxide anaesthesia

Pedersen, Flemming; Nielsen, Janni; Ibsen, M.; Guldager, H

doi:10.1111/j.1399-6576.1993.tb03756.x

Cited by 27 publications

(8 citation statements)

References 5 publications

(1 reference statement)

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“…Logan [17] showed savings in enflurane consumption of up to 86% comparing fresh gas flow rates in different anaesthesia circle systems. Similar observations were made by Pedersen et al [18]. They found an 81% reduction in isoflurane consumption when low fresh gas flows (0.6 -0.7 l/min) in a circle system were compared to high fresh gas flows (minimum 4 l/min).…”

Section: Costs Of Inhaled Anaesthetics -Low-flow Anaesthesiasupporting

confidence: 87%

“…Reducing fresh gas flow worldwide from 5 to 2.5 l/min would save ∼ US$225 million a year [15]. Several studies have analysed the cost per hour for different fresh gas flows [6,[16][17][18][19]. Szocik and Learned [6] calculated that costs per case of inhaled anaesthetic drugs decreased by 21% from US$19.20 to 15.16 simply through applying low-flow anaesthesia after an educational intervention.…”

Section: Costs Of Inhaled Anaesthetics -Low-flow Anaesthesiamentioning

confidence: 99%

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Pharmacoeconomic considerations in anaesthetic use

Kumle

Boldt

2002

Expert Opinion on Pharmacotherapy

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Healthcare costs are rising in all areas of medicine, especially in high technology specialities such as anaesthesia. Therefore, cost containment and reduction have become major goals in many hospitals and anaesthesia departments. One area that has received substantial attention is the cost of pharmaceutical products, in particular the cost of newer, shorter-acting inhaled and intravenous anaesthetics, analgesics and neuromuscular blocking agents. Numerous pharmacoeconomic studies have been published on the theoretical analysis of anaesthetic drug costs and the potential benefit of various anaesthesia techniques. However, the results are not conclusive and anaesthesia departments continue to seek ways to reduce costs. In this review, we intend to discuss cost terminology, common areas of cost containment in anaesthesia and the relationship of anaesthesia care costs to total perioperative costs.

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Section: Costs Of Inhaled Anaesthetics -Low-flow Anaesthesiasupporting

confidence: 87%

Section: Costs Of Inhaled Anaesthetics -Low-flow Anaesthesiamentioning

confidence: 99%

Pharmacoeconomic considerations in anaesthetic use

Kumle

Boldt

2002

Expert Opinion on Pharmacotherapy

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“…However, this produces the highest costs due to wasted gases [ 7 ]. The economic benefits of low-flow anaesthesia are controversial [ 8 , 9 ]. Studies evaluating the cost effectiveness of anaesthetic machines most often look only at the consumption of fresh gases and volatile anaesthetics [ 10 ].…”

Section: Resultsmentioning

confidence: 99%

Cost analysis of two anaesthetic machines: "Primus®" and "Zeus®"

et al. 2012

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BackgroundTwo anaesthetic machines, the "Primus®" and the "Zeus®" (Draeger AG, Lübeck, Germany), were subjected to a cost analysis by evaluating the various expenses that go into using each machine.MethodsThese expenses included the acquisition, maintenance, training and device-specific accessory costs. In addition, oxygen, medical air and volatile anaesthetic consumption were determined for each machine.ResultsAnaesthesia duration was 278 ± 140 and 208 ± 112 minutes in the Primus® and the Zeus®, respectively. The purchase cost was €3.28 and €4.58 per hour of operation in the Primus® and the Zeus®, respectively. The maintenance cost was €0.90 and €1.20 per hour of operation in the Primus® and the Zeus®, respectively. We found that the O2 cost was €0.015 ± 0.013 and €0.056 ± 0.121 per hour of operation in the Primus® and the Zeus®, respectively. The medical air cost was €0.005 ± 0.003 and €0.016 ± 0.027 per hour of operation in the Primus® and the Zeus®, respectively. The volatile anaesthetic cost was €2.40 ± 2.40 and €4.80 ± 4.80 per hour of operation in the Primus® and the Zeus®, respectively.ConclusionThis study showed that the "Zeus®" generates a higher cost per hour of operation compared to the "Primus®".

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“…Although the relative contribution of inhalation anaesthetics to atmospheric pollution is very small (4), anaesthetists should have the duty of minimizing unnecessary pollution. Moreover, the use of LF systems results in substantial financial savings (26).…”

Section: Discussionmentioning

confidence: 99%

Low flow anaesthesia reduces occupational exposure to inhalation anaesthetics Environmental and biological measurements in operating room personnel

Imberti

Preseglio

Imbriani

et al. 1995

Acta Anaesthesiol Scand

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In the present study we evaluated the occupational exposure to N2O and isoflurane during open circuit (OC) (fresh gas flow > or = minute volume) and low flow (LF) (fresh gas flow = 1.5 l/min) anaesthesia. The effects of active scavenging and of a charcoal filter positioned on the exhausting branch of the ventilator on environmental and urinary concentrations of inhalation anaesthetics were also investigated. The study was carried out in the same operating room provided with non-recirculating air changes (10 per hour). It involved anaesthetists and nurses during routine activity. N2O and isoflurane concentrations (time-weighted average) were measured after 3-hour continuous exposure: 1) in the environment at the level of the personnel's breathing zone (Ci); 2) in the environment at the ventilator zone (C); 3) in urine (Cu). During OC anaesthesia without active scavenging the breathing zone concentration of both N2O and isoflurane was very high (194.6 +/- 15.2 and 5.0 +/- 0.4 ppm, respectively). The activation of the scavenging greatly reduced the breathing zone concentration of N2O (31.6 +/- 4.1 ppm) and isoflurane (1.7 +/- 0.2 ppm). LF anaesthesia (with active scavenging) significantly reduced the environmental concentration of both anaesthetics (Ci N2O and isoflurane 22.7 +/- 1.8 and 0.6 +/- 0.04 ppm, respectively). During LF anaesthesia the breathing zone concentration of N2O remained low, even without scavenging (22.7 +/- 1.8 ppm). Similar results were obtained by measuring N2O and isoflurane concentrations at the ventilator zone and in urine.(ABSTRACT TRUNCATED AT 250 WORDS)

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Low‐flow isoflurane‐nitrous oxide anaesthesia offers substantial economic advantages over high‐and medium‐flow isoflurane‐nitrous oxide anaesthesia

Cited by 27 publications

References 5 publications

Pharmacoeconomic considerations in anaesthetic use

Pharmacoeconomic considerations in anaesthetic use

Cost analysis of two anaesthetic machines: "Primus®" and "Zeus®"

Low flow anaesthesia reduces occupational exposure to inhalation anaesthetics Environmental and biological measurements in operating room personnel

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