PHARMACY SAVINGS GENERATED BY PREOPERATIVE ADMINISTRATION OF CLONIDINE

Study Objectives: To evaluate the effects of preoperative administrati on of clonidine by the oral, intramuscular (IM), or epidural routes, o n isoflurane expense during total abdominal hysterectomy. Design: Rand omized, double-blind, placebo-controlled study. Setting: University ho spital. Patients: 80 ASA physical status I and II patients scheduled f or total abdominal hysterectomy. Interventions: Patients were distribu ted into four groups of treatment: oral, IM, epidural, and control. Ea ch group received 300 mu g clonidine according to the treatment group, plus placebo by the other routes. The control group received placebo by all three routes. Depth of anesthesia was evaluated by changes in b lood pressure and heart rate over baseline values. Cost evaluation was based on three components: expense of isoflurane, cost of 300 mu g on clonidine (tablets or ampoules), and the disposable material required to dispense clonidine to each group. Measurements and Main Results: G roups were comparable regarding demographic data, duration and surgery , and time to discharge from recovery room. Postoperatively, none of t he patients had recall of intraoperative events. Clonidine reduced iso flurane pharmacy cost by approximately 45%, regardless of the route of administration. However, when cost of clonidine and the disposable eq uipment used for its administration were taken into account, the cost of the epidural kit surmounted the savings in isoflurane expense. Conc lusion: In the patient population studied, premedication with 300 mu g oral, IM, or epidural clonidine, similarly and significantly reduced the expense of isoflurane during general anesthesia of an approximatel y duration of two hours. However, the cost of the epidural kit offsets the savings in isoflurane. (C) 1998 Elsevier Science Inc.