Cost comparison between three different general anaesthetic techniques forelective arthroscopy of the knee

Introduction: We compared three anaesthetic techniques for elective knee ar throscopy with special reference to cost-effectiveness. Method: Seventy-five ASA I-II patients having elective arthroscopy of the k nee joint were randomised to receive an anaesthetic technique based on prop ofol, fentanyl for induction followed by sevoflurane in oxygen:nitrous oxid e (1:2 1/min) for maintenance of one of two intravenous techniques: propofo l alfentanil or propofol-remifentanil infusions in combination with oxygen in air. Results: All patients had an uncomplicated course. No differences were seen with regard to emergence, postoperative pain or emesis or time to discharg e. The anaesthetic technique based on sevoflurane was associated with the l owest cost US$ 14.7 as compared to US$ 18 for the propfol/alfentanil and US $ 19.9 for the propofol/remifentanil technique, including both cost for was tage as well as premedication and other fixed drug costs. Looking only at t he anaesthetic drugs consumed, the cost per minute was US$ 0.56 for sevoflu rane/nitrous oxide as compared to US$ 0.68 and 0.63 per minute for the prop ofol/alfentanil and proprofol/remifentanil, respectively. When the cost for wastage was taken into account, the difference in mean anaesthetic drug co st was more pronounced: the sevoflurane anaesthetic technique US$ 0.58, the propofol/alfentanil US$ 0.74 and the propofol/remifentanil US$ 0.84 per mi nute respectively. Conclusion: From a cost-minimisation point of view, anaesthesia based on se voflurane in oxygen:nitrous oxide is the technique of choice.