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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med    2012, Vol. 6 Issue (3) : 311-316    https://doi.org/10.1007/s11684-012-0205-7
RESEARCH ARTICLE
Comparative cost analysis of three different anesthesia methods in gynecological laparoscopic surgery
Xiaohui Chi, Yeling Chen, Mingfeng Liao, Fei Cao, Yuke Tian, Xueren Wang()
Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Abstract

In the current study, we assessed and evaluated the costs and benefits of three popular methods of general anesthesia practiced in our department for gynecological laparoscopic surgery in recent years. Sixty adult female patients who underwent elective gynecological laparoscopic surgery under general anesthesia were randomly divided into three groups: group V, group I and group C. In group V, anesthesia was induced intravenously with midazolam, remifentanil, propofol and vecuronium, and maintained with continuous infusion of propofol and remifentanil. In group I, anesthesia was intravenously induced with midazolam, fentanyl, propofol and vecuronium, and maintained with inhaled isoflurane and intravenous bonus of fentanyl. In group C, anesthesia was induced as in group I, but maintained with isoflurane inhalation combined with propofol-remifentanil infusion. All patients received vecuronium for muscle relaxation. Perioperative incidences of complications and total anesthesia costs for patients in all groups were recorded. In addition, postoperative satisfaction of the patients was also noted, and similar outcomes of the satisfaction were reported in all 60 patients. Although there was no statistical significance among groups, the incidence of postoperative nausea and vomiting were higher in group C, and the rates of shivering and the needs for analgesics were higher in group V. Anesthesia costs in group I were the lowest. Therefore, it is concluded that the costs of anesthesia induced with midazolam, fentanyl, propofol, vecuronium, and maintained with isoflurane, fentanyl and vecuronium are cheapest, and there is no significant difference in patients’ satisfaction and safety among the three above-mentioned methods of anesthesia in our department.

Keywords general anesthesia      economics      cost     
Corresponding Author(s): Wang Xueren,Email:xrwang@mail.hust.edu.cn   
Issue Date: 05 September 2012
 Cite this article:   
Xiaohui Chi,Yeling Chen,Mingfeng Liao, et al. Comparative cost analysis of three different anesthesia methods in gynecological laparoscopic surgery[J]. Front Med, 2012, 6(3): 311-316.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-012-0205-7
https://academic.hep.com.cn/fmd/EN/Y2012/V6/I3/311
Group V (n = 20)Group I (n = 20)Group C (n = 20)
Age (year)34±730±530±7
Weight (kg)56±855±755±6
OD (min)96±19104±19101±16
Tab.1  Demographic data
Group V (n = 20)Group I (n = 20)Group C (n = 20)
Cardiovascular reactionsIntubation3 (15%)1 (5%)1 (5%)
Extubation8 (40%)7 (35%)5 (25%)
AtropineInduction1 (5%)0 (0%)2 (10%)
Maintenance0 (0%)0 (0%)1 (5%)
DopamineInduction7 (35%)4 (20%)5 (25%)
Maintenance0 (0%)0 (0%)0 (0%)
Tab.2  Conditions during the operation and anesthesia
Group V (n = 20)Group I (n = 20)Group C (n = 20)
R.S.B.*2.55±1.613.15±2.063.10±1.68
T.E.#5.15±2.066.30±2.995.15±2.06
PACU stay31.75±6.9430.80±5.8530.85±6.88
Tab.3  Emergence and recovery time (min)
Group V (n = 20)Group I (n = 20)Group C (n = 20)
Shivering3 (15%)1 (5%)0 (0%)
Headache0 (0%)0 (0%)1 (5%)
Awareness0 (0%)0 (0%)0 (0%)
Nausea5 (25%)6 (30%)6 (50%)
Vomiting4 (20%)4 (20%)9 (45%)
Dizziness1 (5%)3 (15%)2 (10%)
Chest distress0 (0%)0 (0%)1 (5%)
Agitation0 (0%)2 (10%)0 (0%)
Tab.4  Postoperative complications
Group V (n = 20)Group I (n = 20)Group C (n = 20)
OAAS(1/2/3/4/5)Extubation0/ 3/ 7/10/ 00/ 1/10/ 9/ 00/ 1/ 6/13/ 0
1 h P.O.*0/ 0/ 0/ 3/170/ 0/ 0/ 7/130/ 0/ 0/ 5/15
3 h P.O.0/ 0/ 0/ 0/200/ 0/ 0/ 1/190/ 0/ 0/ 1/19
24 h P.O.0/ 0/ 0/ 0/200/ 0/ 0/ 0/200/ 0/ 0/ 0/20
VRS(0/1/2/3/4)In PACU11/ 6/ 3/ 0/ 013/ 4/ 2/ 1/ 013/ 5/ 2/ 0/ 0
1 h P.O.1/ 6/12/ 1/ 06/ 6/ 7/ 1/ 02/12/ 4/ 2/0
3 h P.O.7/ 5/ 7/ 1/ 09/ 5/ 5/ 1/ 04/ 8/ 6/ 2/ 0
24 h P.O.16/ 3/ 1/ 0/ 017/ 3/ 0/ 0/ 018/ 2/ 0/ 0/ 0
Demands of analgesic734
Tab.5  OAAS, VRS scores and demands for analgesic
Group V (n = 20)Group I (n = 20)Group C (n = 20)
More pleasant16 (80%)15 (75%)12 (60%)
As pleasant as3 (15%)5 (25%)8 (40%)
Worse1 (5%)0 (0%)0 (0%)
Tab.6  Patients’ satisfaction
Fig.1  Costs of the anesthesia. Costs of all drugs per case used during the anesthesia were calculated and then compared with one-way ANOVA ( = 20 in each group). The costs in group I was the lowest, and was the highest in group V in our study. * <0.05 when compared among the three groups.
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