Use of propofol does not increase the cost of patient's management in cardiac surgery with cardiopulmonary bypass.

Objectives: Evaluation of the cost of propofol used for fast-track in cardi ac surgery and its impact on global cost of management for anaesthesia and intensive care. Study design: Case-control study, prospective (1998) and retrospective (199 4). Patients: Twenty patients operated for cardiac surgery in 1998 and schedule d for fast-track anaesthesia. Twenty patients in 1994 matched for different criteria to the patient of 1998. Methods: In 1998, all drugs, materials used and X-rays, biochemical assays performed were prospectively collected and their cost calculated. In 1994, similar calculations were done retrospectively. Comparison of duration of m echanical ventilation, hospitalization in intensive care and in the hospita l were performed. Results: Cost of anaesthesia was similar in 1994 and 1998 (2 646 FF versus 2 294 FF). Global cost of management was significantly lower in 1998 in com parison to 1994 (5 439 FF versus 8 558 FF). Duration of mechanical ventilat ion, hospitalization in intensive care and in the hospital were shorter in 1998 than in 1994. Conclusion: Despite a higher cost of propofol for anaesthesia and postopera tive sedation in comparison to midazolam, the global cost of management dec reased significantly in relation to a one day decrease in hospitalization i n the intensive care unit. (C) 2000 Editions scientifiques et medicales Els evier SAS.