A multicentre comparison of the costs of anaesthesia with sevoflurane or propofol

Day-case anaesthesia requires rapidly eliminated anaesthetics which are rel atively expensive. This multinational, multicentre European study assessed the relative costs of propofol or sevoflurane anaesthesia in 211 patients. Anaesthesia was induced and maintained with propofol in group 1, with propo fol and sevoflurane in group 2, and with sevoflurane in group 3. Drug and d elivery costs were calculated in US$. Induction of anaesthesia was fastest in groups 1 and 2, although spontaneous ventilation resumed earliest in gro up 3. Emergence times and times at which patients were fit for discharge we re similar in all groups. Group 2 had the lowest costs based on actual drug use (mean $14.2 (SEM 0.8) Vs $18.7 (0.8) and $17.3 (0.8) in groups 1 and 3 , respectively). Anaesthetic drug wastage and disposable costs were highest in group I and lowest in group 3. Consequently, total costs were highest i n group 1 ($31.9 (0.9)) compared with groups 2 ($19.7 (0.9)) and 3 ($18.8 ( 0.9)). Although we observed increased nausea and vomiting in groups 2 and 3 and reduced patient satisfaction in group 3, these differences should be b alanced against the greater cost of propofol anaesthesia.