Cost analysis of xenon anesthesia: A comparison with nitrous oxide-isoflurane and nitrous oxide-sevoflurane anesthesia

Study Objective: To determine the cost of xenon (Xe) anesthesia in relation to the anesthetic duration by conducting a cost analysis of this relativel y expensive inhaled anesthetic. Design: Cost analysis based on the literature on Xe anesthesia. Setting: Anesthetic simulation based on data obtained in the operating room s at a university hospital. Patients: A 40-year-old ASA physical status I adult patient model weighing 70 kg; undergoing elective minor surgery with endotracheal intubation and m echanical ventilation. Interventions: Anesthesia was given in the following four techniques: 1) cl osed-circuit technique with Xe; 2) closed-circuit technique with nitrous ox ide (N2O)-isoflurane; 3) semiclosed technique with N2O-isoflurane; and 4) s emiclosed technique with N2O-sevoflurane. Measurements and Main Results: Cost of each anesthetic technique was compar ed in U.S. dollars. The cost of Xe anesthesia was consistently higher than that of N2O-isoflurane or N2O-sevoflurane (for 240-min anesthesia; $356 wit h Xe, $52 with closed-circuit N2O-isoflurane, $94 with semiclosed N2O-isofl urane, and $84 with semiclosed N2O-sevoflurane). The major cost of Xe anest hesia was a result of the cost of priming and flushing; the cost of Xe used for its anesthetic effects was comparable with the other semiclosed techni ques after 240 minutes. Conclusions: For Xe to be widely used in routine anesthesia, the methods of minimizing the amount of Xe necessary for priming and flushing must be dev eloped. (C) 1999 by Elsevier Science Inc.