Cost-effectiveness and high patient satisfaction in the elderly: sevoflurane versus propofol anaesthesia

Eur J Anaesthesiol. 2004 Feb;21(2):115-22. doi: 10.1017/s0265021504002066.

Abstract

Background and objective: The use of propofol compared with isoflurane is associated with improved patient comfort and decreased costs. However, as the cost saving, the quicker recovery time and patient comfort may not be evident if sevoflurane is substituted for isoflurane; these two anaesthetic agents were analysed in elderly patients.

Methods: In a prospective randomized study, 96 patients undergoing elective ophthalmic surgery received either total intravenous anaesthesia with propofol (Group P), propofol for induction and sevoflurane for maintenance (Group P/S) or sevoflurane for inhalation induction and maintenance (Group S). Analyses focussed on haemodynamics, the quality of recovery, and the costs for the anaesthetic and the entire procedure.

Results: Bradycardia or hypotension, mainly registered in Groups P and P/S, did not influence patients' recovery. In Group S, postoperative nausea and vomiting occurred frequently, and 50% of patients complained of discomfort during induction. In Group P/S, the costs for anaesthetics and total costs were lower than those in Groups P and S.

Conclusions: Propofol- and sevoflurane-based maintenance of anaesthesia were similar with regard to patient comfort and recovery in the elderly. Cost analysis revealed that it was less expensive to use propofol for induction and sevoflurane for maintenance than to use either propofol or sevoflurane as sole agents for anaesthesia.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analysis of Variance
  • Anesthesia Recovery Period
  • Anesthetics, Inhalation / adverse effects
  • Anesthetics, Inhalation / economics
  • Anesthetics, Inhalation / therapeutic use
  • Anesthetics, Intravenous / economics
  • Anesthetics, Intravenous / therapeutic use
  • Blood Pressure / drug effects
  • Bradycardia / chemically induced
  • Bradycardia / prevention & control
  • Cost-Benefit Analysis
  • Elective Surgical Procedures
  • Female
  • Germany
  • Health Care Costs / statistics & numerical data*
  • Heart Rate / drug effects
  • Humans
  • Hypotension / chemically induced
  • Hypotension / prevention & control
  • Male
  • Methyl Ethers / adverse effects*
  • Methyl Ethers / economics*
  • Methyl Ethers / therapeutic use
  • Ophthalmologic Surgical Procedures* / economics
  • Ophthalmologic Surgical Procedures* / methods
  • Patient Satisfaction / economics
  • Patient Satisfaction / statistics & numerical data*
  • Postoperative Complications / chemically induced
  • Postoperative Complications / prevention & control
  • Propofol / adverse effects*
  • Propofol / economics*
  • Propofol / therapeutic use
  • Prospective Studies
  • Sevoflurane
  • Time Factors

Substances

  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Methyl Ethers
  • Sevoflurane
  • Propofol