Cost comparison of sevoflurane with isoflurane anesthesia in arthroscopic menisectomy surgery

Purpose: To determine the "real world" cost of sevoflurane compared with is oflurane in balanced general anesthesia for daycare arthroscopic menisectom y, we prospectively investigated perioperative drug requirement and expense as well as recovery time. Methods: Following intravenous induction, 40 consenting adult patients rand omly received either sevoflurane- or isoflurane-based anesthesia with a sta ndardized gas inflow rate of 3 1.min. Recovery was assessed in the postanes thetic recovery room (PARR) in a double-blind manner at 15 min intervals us ing the Aldrete scoring system until patients met discharge criteria. Results: Patient demographics, anesthetic duration, volatile potency and ad junct drug requirements were similar in the two groups. Total perioperative drug cost per patient was CAN$38.10 +/- 10.13 (mean +/- SD) for the sevofl urane group and $23.87 +/- 6.59 for the isoflurane group (P < 0.01). Althou gh the nonvolatile drug cost was comparable between the two groups, the vol atile drug cost per patient was $19.40 +/- 8.80 for sevoflurane and $4.50 /- 1.90 for isoflurane (P < 0.01). This four-fold sevoflurane-to-isoflurane cost difference was the product of two ratios, both based on the volume of liquid anesthetic: the ratio of consumption, 2.1; and the ratio of institu tional price, 2.1. Intraoperative hemodynamic response, time until discharg e from the PARR and incidences of postoperative nausea and vomiting did not significantly differ between the two groups. Conclusions: When used to maintain equipotent balanced general anesthesia f or daycare arthroscopic menisectomy, volatile consumption and cost were gre ater for sevoflurane compared with isoflurane. Nonvolatile perioperative dr ug cost and recovery times were similar, however, in the two groups.