A cost comparison of methohexital and propofol for ambulatory anesthesia

Methohexital is eliminated more rapidly than thiopental, and early recovery compares favorably with propofol. We designed this study to evaluate the r ecovery profile when methohexital was used as an alternative to propofol fo r the induction of anesthesia before either sevoflurane or desflurane in co mbination with nitrous oxide. One hundred twenty patients were assigned ran domly to one of four anesthetic groups: (I) methohexital-desflurane, (II) m ethohexital-sevoflurane, (III) propofol-desflurane, or (TV) propofol-sevofl urane. Recovery times after the anesthetic drugs, as well as the perioperat ive side effect profiles, were similar in all four groups. A cost-minimizat ion analysis revealed that methohexital was less costly for the induction o f anesthesia. At the fresh gas flow rates used during this study, the costs of the volatile anesthetics for maintenance of anesthesia did not differ a mong the four groups. However, at low flow rates (less than or equal to 1 L /min), the methohexital-desflurane group would have been the least expensiv e anesthetic technique. In conclusion, methohexital is a cost-effective alt ernative to propofol for the induction of anesthesia in the ambulatory sett ing. At low fresh gas flow rates, the methohexital-desflurane combination w as the most cost-effective for the induction and maintenance of general ane sthesia. Implications: Using methohexital as an alternative to propofol for the induction of anesthesia for ambulatory surgery seems to reduce drug co sts. When fresh gas flow rates less than or equal to 1 L/min are used, the combination of methohexital for the induction and desflurane for maintenanc e may be the most cost-effective general anesthetic technique for ambulator y surgery.