Epple J, Kubitz J, Schmidt H, Motsch J, Böttiger B W, Martin E, Bach A
Department of Anaesthesiology, University of Heidelberg, Heidelberg, Germany.
Eur J Anaesthesiol. 2001 Jan;18(1):20-8. doi: 10.1046/j.1365-2346.2001.00764.x.
We evaluated the costs and benefits of total intravenous anaesthesia compared with a balanced anaesthesia regimen.
One-hundred and twenty-four patients undergoing cataract surgery were randomized to either a propofol/remifentanil or an isoflurane/fentanyl group. In the propofol/remifentanil group, both drugs were used for induction and maintenance of anaesthesia; in the isoflurane/fentanyl group, anaesthesia was induced with etomidate and fentanyl and maintained with isoflurane and fentanyl. All patients received mivacurium for muscle relaxation and the lungs were ventilated mechanically. The use of propofol and remifentanil resulted in a faster emergence and an overall savings per case of [symbol: see text] 12.25 due to a reduction in personnel costs which outweighs the higher drug acquisition costs.
In the propofol and remifentanil group, more patients were satisfied and would accept the same anaesthetic again.
We conclude that propofol and remifentanil is more cost-effective than isoflurane/fentanyl due to its better recovery profile, reduced total direct costs and higher patient satisfaction.
我们评估了全静脉麻醉与平衡麻醉方案相比的成本和效益。
124例接受白内障手术的患者被随机分为丙泊酚/瑞芬太尼组或异氟烷/芬太尼组。在丙泊酚/瑞芬太尼组中，两种药物均用于麻醉诱导和维持；在异氟烷/芬太尼组中，依托咪酯和芬太尼用于麻醉诱导，异氟烷和芬太尼用于维持麻醉。所有患者均接受米库氯铵进行肌肉松弛，并行机械通气。使用丙泊酚和瑞芬太尼导致苏醒更快，且由于人员成本降低，每例总体节省12.25欧元，这超过了较高的药品采购成本。
在丙泊酚和瑞芬太尼组中，更多患者感到满意，并愿意再次接受相同的麻醉。
我们得出结论，丙泊酚和瑞芬太尼比异氟烷/芬太尼更具成本效益，因为其恢复情况更好，总直接成本降低，患者满意度更高。
