Pharmacoeconomics of desflurane based minimal flow anesthesia for different durations of surgery

Abstract

Background: Desflurane is relatively newer volatile anesthetic in clinical practice with many advantages. Unfortunately, it is comparatively costlier. The present observational study is aimed to evaluate the consumption pattern and cost of Desflurane based minimal flow anesthesia with regards to different durations of anesthesia. Methods: Twenty adults of American Society of Anesthesiologists’ class I and II of either sex were enrolled for the study with informed consent during November 2015 to January 2016. Anesthesia was performed using Intermed Penlon sigma Alfa Desflurane vaporizer and Penlon Prima SP2 workstation. Age and opioid compensated minimum alveolar concentration was fixed for each patient and was monitored using Penlon SP M8 monitor and its attached anesthesia gas monitoring system. Bispectral index was used in affordable patients to monitor depth of anesthesia. Data of Desflurane consumption was collected from the digital numerical display on the vaporizer screen. Statistical analysis was done using INSTAT software and cost was calculated from maximum retail price. Results: Data from 20 patients consisting 60% male (mean + standard deviation age of 39.8 + 16.9 years and weight of 59.7 + 12.52 kilograms) were analyzed. Gender had no effect on consumption of Desflurane. Older patients (>60 years) consumed less than the younger (p<0.05). Mean Desflurane consumption was highest during first 5 minute (6.2 ml) and followed decreasing trend till 45 minute of anesthesia (p<0.05) followed by a near steady consumption. Cost of Desflurane reduced from Indian Rupees 22/minute for 15 minute anesthesia to Indian Rupees 6/minutes for 3 hours anesthesia. Conclusions: Desflurane consumption and cost do not depend on sex but on age, flow and time. It becomes more cost-effective for relatively longer duration of minimal flow anesthesia.