Propofol anaesthesia in paediatric ambulatory patients: a comparison with thiopentone and halothane

Hannallah, Raafat S.; Britton, John T.; Schafer, Patrick G.; Patel, Ramesh I.; Norden, Janet M.

doi:10.1007/bf03009654

Cited by 79 publications

(27 citation statements)

References 18 publications

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“…The direction of the treatment effect in favour of propofol ⁄ propofol is supported by the literature. PONV incidence in the trial is at the low end of the reported range [19][20][21][22]. The direction of the treatment effect in favour of propofol ⁄ propofol is supported by the literature.…”

Section: Discussionsupporting

confidence: 54%

Clinical and economic choices in anaesthesia for day surgery: A prospective randomised controlled trial

Elliott

Payne

Moore³

et al. 2003

Anaesthesia

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SummaryWe compared the cost-effectiveness of general anaesthetic agents in adult and paediatric day surgery populations. We randomly assigned 1063 adult and 322 paediatric elective patients to one of four (adult) or two (paediatric) anaesthesia groups. Total costs were calculated from individual patient resource use to 7 days post discharge. Incremental cost-effectiveness ratios were expressed as cost per episode of postoperative nausea and vomiting (PONV) avoided. In adults, variable secondary care costs were higher for propofol induction and propofol maintenance (propofol ⁄ propofol; p < 0.01) than other groups and lower in propofol induction and isoflurane maintenance (propofol ⁄ isoflurane; p < 0.01). In both studies, predischarge PONV was higher if sevoflurane ⁄ sevoflurane (p < 0.01) was used compared with use of propofol for induction. In both studies, there was no difference in postdischarge outcomes at Day 7. Sevoflurane ⁄ sevoflurane was more costly with higher PONV rates in both studies. In adults, the cost per extra episode of PONV avoided was £296 (propofol ⁄ propofol vs. propofol ⁄ sevoflurane) and £333 (propofol ⁄ sevoflurane vs. propofol ⁄ isoflurane).

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Section: Discussionsupporting

confidence: 54%

Clinical and economic choices in anaesthesia for day surgery: A prospective randomised controlled trial

Elliott

Payne

Moore³

et al. 2003

Anaesthesia

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“…Propofol induction followed by propofol maintenance showed the least hemodynamic changes in pediatric patients versus induction with thiopental, propofol, or halothane followed by halothane maintenance (Hannallah, Britton, Schafer, Patel, & Norden, 1994). Patients receiving propofol demonstrated significantly less airway resistance versus thiopental or etomidate (Eames, Rooke, Wu, & Bishop, 1996).…”

Section: Problem Of Reducing Costsmentioning

confidence: 91%

Comparison Of The Direct Costs, Length Of Recovery, And Incidence Of Post Operative Anti Emetic Use After Anesthesia Induction With Propofol Or A 1:1 Mixture Of Thiopental And Propofol

Killpack¹

1999

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Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. The modern anesthesia provider must consider drug costs as important as benefits and risks when choosing which drug to use in an anesthetic. Thiopental has been the gold standard for an IV induction drug although propofol shows a better recovery profile with less post-operative nausea and vomiting, but at a higher cost. We attempted to determine if a 1:1 volume mixture of thiopental and propofol would show a similar recovery profile compared to propofol alone, but at a lower cost. This study examined the records of 212 surgery patients receiving propofol (n=82) or a 1:1 mixture (n=130) for demographic, peri-operative, PACU recovery, anti-emetic use, and cost data. We found that the propofol group had significantly more females, postoperative anti-emetic use, and induction drug costs, while the 1:1 mixture group had significantly longer surgery and anesthesia times. Mean post-operative anti-emetic drug costs were statistically significant (P<0.05) at $3.15 for the propofol group and $1.08 for the 1:1 mixture group. The mean cost of induction for the propofol group was $27.31 and $14.31 for the 1:1 mixture group, a statistically significant (P<0.05) difference of $13.09. The average recovery time for the propofol group was 134 minutes and cost $1205.37, and for the 1:1 mixture group 147 minutes and cost $1320.03. Thus, the difference in PACU charges was $114.66. This research suggests that the 1:1 mixture of thiopental and propofol produced a similar recovery profile to propofol alone, but at a lower direct cost. This study supported previous work, and recommends that further research be done to confirm its findings. ix ACKNOWLEDGEMENT SUBJECT TERMS

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“…139,146,157 Cheng and co-workers 139 reported a reduction in PONV in hospital with propofol, but Runcie and co-workers 157 and Hannallah and co-workers 146 did not find this. Runcie and co-workers 157 reported that early recovery was more rapid with propofol than with thiopentone, but earlier discharge occurred only in older children.…”

Section: Thiopentone Versus Propofolmentioning

confidence: 99%

Which anaesthetic agents are cost-effective in day surgery? Literature review, national survey of practice and randomised controlled trial

Elliott

Payne

Moore

et al. 2002

Health Technol Assess

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Propofol anaesthesia in paediatric ambulatory patients: a comparison with thiopentone and halothane

Cited by 79 publications

References 18 publications

Clinical and economic choices in anaesthesia for day surgery: A prospective randomised controlled trial

Clinical and economic choices in anaesthesia for day surgery: A prospective randomised controlled trial

Comparison Of The Direct Costs, Length Of Recovery, And Incidence Of Post Operative Anti Emetic Use After Anesthesia Induction With Propofol Or A 1:1 Mixture Of Thiopental And Propofol

Which anaesthetic agents are cost-effective in day surgery? Literature review, national survey of practice and randomised controlled trial

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