Comparative analysis of costs of total intravenous anaesthesia with propofol and remifentanil vs. balanced anaesthesia with isoflurane and fentanyl

Background and aim We evaluated the costs and benefits of total intravenous anaesthesia compared with a balanced anaesthesia regimen. Methods One-hundred and twenty-four patients undergoing cataract surgery we re randomized to either a propofol/remifentanil or an isoflurane/fentanyl g roup. In the propofol/remifentanil group, both drugs were used for inductio n and maintenance of anaesthesia; in the isoflurane/fentanyl group, anaesth esia was induced with etomidate and fentanyl and maintained with isoflurane and fentanyl. All patients received mivacurium for muscle relaxation and t he lungs were ventilated mechanically. The use of propofol and remifentanil resulted in a faster emergence and an overall savings per case of (sic) 12 .25 due to a reduction in personnel costs which outweighs the higher drug a cquisition costs. Results In the propofol and remifentanil group, more patients were satisfie d and would accept the same anaesthetic again. Conclusion We conclude that propofol and remifentanil is more cost-effectiv e than isoflurane/fentanyl due to its better recovery profile, reduced tota l direct costs and higher patient satisfaction.