The Consumption of Anesthetic Agents During One-lung Ventilation and a Cost Analysis: a Comparison of Two Techniques

Abstract

This prospective, randomized clinical trial aims to compare the direct cost of two anesthetic techniques used in thoracic surgery during one-lung ventilation (OLV). Methods: In this study, adult patients scheduled for thoracic surgery under general anesthesia were randomized to receive either inhalational (deflurane) or total intravenous anesthesia (propofol), with a continuous infusion of remifentanil in both groups. The depth of anesthesia was maintained at a sustained bispectral index value of 40±10. The total quantity of drugs dispensed was estimated, and a cost analysis was performed using hospital pharmacy prices. The patients' demographic information, perioperative characteristics, and recovery time needed to achieve a modified Aldrete score of ≥8 were recorded. Results: In total, 60 patients were enrolled in this study. Patients' demographic details and the duration of anesthesia were comparable between groups. There was no statistically significant difference between the groups with respect to perioperative surgical characteristics. In a 2 L/minute fresh gas flow, the consumption of desflurane was 120.9±75.37 mL. The cost of desflurane-balanced anesthesia was significantly greater than that of propofol (p<0.001) with comparable clinical characteristics. Conclusion: Inhalational-based balanced anesthesia is an important point of consideration from a pharmacoeconomical aspect. Low flow anesthesia studies will be important for costsaving in all general anesthesia applications using inhalational anesthetics, including OLV used during thoracic surgery.