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Canadian Journal of Anesthesia

, Volume 49, Issue 4, pp 339–346 | Cite as

Desflurane improves the throughput of patients in the PACU. A cost-effectiveness comparison with isoflurane

  • Marc Beaussier
  • Anne Decorps
  • Patrick Tilleul
  • Alexandre Megnigbeto
  • Pierre Balladur
  • André Lienhart
General Anesthesia

Abstract

Purpose

In a pharmacoeconomic approach of anesthesia, postanesthesia care unit (PACU) occupancy can be chosen as a criteria of effectiveness to compare two anesthetic drugs with different rates of elimination and different costs of administration. Our objective was to develop a cost-effectiveness approach for the comparison of isoflurane (I) and desflurane (D).

Method

In this prospective observational study, 68 patients aged 18–70 received either D or I for maintenance of anesthesia for inpatient abdominal procedures. Length of stay (LOS) in PACU was collected by a blinded observer. After the relationship between duration of surgery and LOS in PACU had been established in the 68 observed patients, we estimated the PACU occupancy according to duration of surgery and time of admission in PACU using a computer model of 204 consecutive patients, based on the hypothesis of an exclusive use of either D or I. Outcome measures were direct costs of the anesthesia procedure and occupancy of the PACU.

Results

The direct cost of the anesthetic was significantly higher with D than with I. This represents an increase of CAN$ 2 708 for the 204 patients. PACU occupancy was reduced by at least one patient (out of five beds) during 26.1 % of the time with D (P < 0.01).

Discussion

Improving the throughput of patients in PACU by using new halogenated anesthetic agents with faster rates of elimination may outweigh the incremental cost of this strategy. This becomes particularly meaningful in operating theatres experiencing frequent overcrowded periods.

Keywords

Isoflurane Sufentanil Atracurium Desflurane Anesthetic Drug 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

L’usage du desflurane permet de réduire l’occupation de la SDR : étude de rentabilité comparée avec l’isoflurane

Résumé

Objectif

L’occupation de la salle de réveil (SDR) peut être choisie comme critère pour réaliser une étude coût-efficacité entre deux agents d’anesthésie de coûts d’administration différents. Le but du présent travail est de réaliser une comparaison coût-efficacité entre l’isoflurane (I) et le desflurane (D).

Méthode

Dans cette étude prospective observationelle, 68 patients de 18 à 70 ans, hospitalisés pour une intervention chirurgicale abdominale, ont reçu soit I, soit D pour le maintien de l’anesthésie. La durée de séjour (DDS) en SDR était mesurée par un observateur indépendant. Après avoir établi la relation liant la durée opératoire et la DDS en SDR pour les 68 patients observés, nous avons bâti un modèle permettant de prédire l’occupation en SDR en fonction de la durée d’opération et de l’heure d’arrivée en SDR pour 204 patients consécutifs avec l’hypothèse d’une utilisation exclusive soit de I, soit de D. Les paramètres évalués ont été le coût d’administration et l’occupation de la SDR.

Résultats

Pour les 204 patients du modèle, le surcoût lié à l’utilisation de D a été de 2 708 $ CAN. Avec le D, l’occupation de SDR a été réduite d’au moins un patient (sur cinq postes) durant 26 % du temps d’ouverture de la SDR (P < 0,01).

Conclusion

La réduction de l’occupation de la SDR peut compenser le surcoût entraîné par l’usage de D par rapport à I. Cela est particulièrement intéressant dans les SDR où il existe des périodes de saturation.

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Copyright information

© Canadian Anesthesiologists 2002

Authors and Affiliations

  • Marc Beaussier
    • 1
  • Anne Decorps
    • 2
  • Patrick Tilleul
    • 2
  • Alexandre Megnigbeto
    • 4
  • Pierre Balladur
    • 3
  • André Lienhart
    • 1
  1. 1.Department of Anesthesia and Intensive CareParisFrance
  2. 2.Department of PharmacyParisFrance
  3. 3.Department of SurgeryParisFrance
  4. 4.St Antoine University Hospital, and the University Paris XIIIParisFrance

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