Skip to main content
Erschienen in: PharmacoEconomics 6/2000

01.06.2000 | Review Article

Low-Flow Anaesthesia

Does it have Potential Pharmacoeconomic Consequences?

verfasst von: Dr Stefan Suttner, Joachim Boldt

Erschienen in: PharmacoEconomics | Ausgabe 6/2000

Einloggen, um Zugang zu erhalten

Abstract

Healthcare reform has placed increasing pressure on anaesthetists to consider the costs of current anaesthesia strategies. Although the cost of anaesthesia constitutes only a small proportion of total healthcare costs, anaesthetic drug expenditures have been a focus of cost-containment efforts. Low-flow anaesthesia is a simple method of reducing the fresh gas flow rate for anaesthetic gases during inhalational anaesthesia. A knowledge of the pharmacokinetic behaviour of inhaled anaesthetics and the use of modern equipment and monitoring technology meet the requirements for safe application of this anaesthetic technique. Millions of patients receive general anaesthesia each year, and thus the use of this technique could generate substantial savings in anaesthetic drug expenditure without reducing the patient’s comfort or increasing adverse events.
The new inhaled anaesthetics desflurane and sevoflurane, which have low tissue solubility, provide promising options when used in low-flow anaesthesia. Apart from the economic advantages, low-flow anaesthesia helps to reduce environmental pollution and is associated with several physiological benefits for the patient. Low-flow anaesthesia is a simple but highly effective method of cost minimisation that can be applied to a large number of patients without any compromise in patient care or safety.
Literatur
2.
3.
Zurück zum Zitat Watcha MF, White P. Is the introduction of new anesthetic drugs and techniques economically justified? Curr Opin Anaesth 1997; 10: 158–62CrossRef Watcha MF, White P. Is the introduction of new anesthetic drugs and techniques economically justified? Curr Opin Anaesth 1997; 10: 158–62CrossRef
4.
Zurück zum Zitat Johnstone RE, Jozefcyk KG. Cost of anesthetic drugs: experience with a cost education trial. Anesth Analg 1994; 78: 766–71PubMed Johnstone RE, Jozefcyk KG. Cost of anesthetic drugs: experience with a cost education trial. Anesth Analg 1994; 78: 766–71PubMed
5.
Zurück zum Zitat Szocik JF, Learned DW. Impact of a cost containment program on the use of volatile anesthetics and neuromuscular blocking drugs. J Clin Anesth 1994; 6: 378–82PubMedCrossRef Szocik JF, Learned DW. Impact of a cost containment program on the use of volatile anesthetics and neuromuscular blocking drugs. J Clin Anesth 1994; 6: 378–82PubMedCrossRef
6.
Zurück zum Zitat Becker KE, Carrithers J. Practical methods of cost containment in anesthesia and surgery. J Clin Anesth 1994; 6: 388–99PubMedCrossRef Becker KE, Carrithers J. Practical methods of cost containment in anesthesia and surgery. J Clin Anesth 1994; 6: 388–99PubMedCrossRef
8.
Zurück zum Zitat Lowe HJ, Ernst EA. The quantitative practice of anesthesia: use of closed circuits. Baltimore (MD): Williams & Wilkins, 1981 Lowe HJ, Ernst EA. The quantitative practice of anesthesia: use of closed circuits. Baltimore (MD): Williams & Wilkins, 1981
9.
Zurück zum Zitat Baker AB. Low flow and closed circuits. Anaesth Intensive Care 1994; 22: 341–2PubMed Baker AB. Low flow and closed circuits. Anaesth Intensive Care 1994; 22: 341–2PubMed
10.
11.
Zurück zum Zitat Perkins R, Meakin G. Economics of low-flow anaesthesia in children. Anaesthesia 1996; 51: 1089–92PubMedCrossRef Perkins R, Meakin G. Economics of low-flow anaesthesia in children. Anaesthesia 1996; 51: 1089–92PubMedCrossRef
12.
Zurück zum Zitat Kleemann PP. Humidity of anaesthetic gases with respect to low flow anaesthesia. Anaesth Intensive Care 1994; 22: 396–408PubMed Kleemann PP. Humidity of anaesthetic gases with respect to low flow anaesthesia. Anaesth Intensive Care 1994; 22: 396–408PubMed
13.
Zurück zum Zitat Bengtson JP, Sonander H, Stenqvist O. Preservation of humidity and heat of respiratory gases during anaesthesia: a laboratory investigation. Acta Anaesthesiol Scand 1987; 31: 127–31PubMedCrossRef Bengtson JP, Sonander H, Stenqvist O. Preservation of humidity and heat of respiratory gases during anaesthesia: a laboratory investigation. Acta Anaesthesiol Scand 1987; 31: 127–31PubMedCrossRef
14.
Zurück zum Zitat Sherman SJ, Cullen BF. Nitrous oxide and the greenhouse effect. Anesthesiology 1988; 68: 816–7PubMedCrossRef Sherman SJ, Cullen BF. Nitrous oxide and the greenhouse effect. Anesthesiology 1988; 68: 816–7PubMedCrossRef
15.
Zurück zum Zitat Nörreslet J, Friberg S, Neilsen, et al. Halothane anaesthetic and the ozone layer [letter]. Lancet 1989; I: 719CrossRef Nörreslet J, Friberg S, Neilsen, et al. Halothane anaesthetic and the ozone layer [letter]. Lancet 1989; I: 719CrossRef
17.
Zurück zum Zitat Johnstone RE, Martinec CL. Costs of anesthesia. Anesth Analg 1993; 76: 840–8PubMed Johnstone RE, Martinec CL. Costs of anesthesia. Anesth Analg 1993; 76: 840–8PubMed
19.
Zurück zum Zitat Macario A, Vitez TS, Dunn B, et al. Where are the costs in perioperative care? Analysis of hospitals costs and charges for inpatient surgical care. Anesthesiology 1995; 83: 1138–44PubMedCrossRef Macario A, Vitez TS, Dunn B, et al. Where are the costs in perioperative care? Analysis of hospitals costs and charges for inpatient surgical care. Anesthesiology 1995; 83: 1138–44PubMedCrossRef
20.
Zurück zum Zitat Hawkes C, Miller D, Martineau R, et al. Evaluation of cost minimization strategies of anesthetic drugs in a tertiary care hospital. Can J Anesth 1994; 41: 894–901PubMedCrossRef Hawkes C, Miller D, Martineau R, et al. Evaluation of cost minimization strategies of anesthetic drugs in a tertiary care hospital. Can J Anesth 1994; 41: 894–901PubMedCrossRef
21.
Zurück zum Zitat Rosenberg MK, Bridge P, Brown M. Cost comparison: a desflurane versus a propofol based general anaesthesia technique. Anesth Analg 1994; 79: 852–5PubMed Rosenberg MK, Bridge P, Brown M. Cost comparison: a desflurane versus a propofol based general anaesthesia technique. Anesth Analg 1994; 79: 852–5PubMed
22.
Zurück zum Zitat Morscher AH, Smith CE, Gordon GJ, et al. A simple spreadsheet tool for cost accounting anaesthesia care. Anesthesiology 1994; 81: 514–6PubMedCrossRef Morscher AH, Smith CE, Gordon GJ, et al. A simple spreadsheet tool for cost accounting anaesthesia care. Anesthesiology 1994; 81: 514–6PubMedCrossRef
23.
Zurück zum Zitat Wetchler B. Economic impact of anesthesia decision making: they pay the money, we make the choice. J Clin Anesth 1992; 4: 20S-4SCrossRef Wetchler B. Economic impact of anesthesia decision making: they pay the money, we make the choice. J Clin Anesth 1992; 4: 20S-4SCrossRef
24.
Zurück zum Zitat Weiskopf RB, Eger EI. Comparing the cost of inhaled anaesthetics. Anesthesiology 1993; 79: 1413–8PubMedCrossRef Weiskopf RB, Eger EI. Comparing the cost of inhaled anaesthetics. Anesthesiology 1993; 79: 1413–8PubMedCrossRef
25.
Zurück zum Zitat Lampotang S, Nyland ME, Gravenstein N. The cost of wasted anesthetic gases [abstract]. Anesth Analg 1991; 72: S151CrossRef Lampotang S, Nyland ME, Gravenstein N. The cost of wasted anesthetic gases [abstract]. Anesth Analg 1991; 72: S151CrossRef
26.
Zurück zum Zitat Cotter SM, Petros AJ, Dore CJ, et al. Low-flow anaesthesia: practice, cost implications and acceptability. Anaesthesia 1991; 46: 1009–12PubMedCrossRef Cotter SM, Petros AJ, Dore CJ, et al. Low-flow anaesthesia: practice, cost implications and acceptability. Anaesthesia 1991; 46: 1009–12PubMedCrossRef
27.
Zurück zum Zitat Logan M. Breathing systems: effect of fresh gas flow rate on enflurane consumption. Br J Anaesth 1994; 73: 775–8PubMedCrossRef Logan M. Breathing systems: effect of fresh gas flow rate on enflurane consumption. Br J Anaesth 1994; 73: 775–8PubMedCrossRef
28.
Zurück zum Zitat Pedersen M, Nielsen J, Ibsen M, et al. Low-flow isofluranenitrous oxide anaesthesia offers substantial economic advantages over high- and medium-flow isoflurane-nitrous oxide anaesthesia. Acta Anaesthesiol Scand 1993; 37: 509–12PubMedCrossRef Pedersen M, Nielsen J, Ibsen M, et al. Low-flow isofluranenitrous oxide anaesthesia offers substantial economic advantages over high- and medium-flow isoflurane-nitrous oxide anaesthesia. Acta Anaesthesiol Scand 1993; 37: 509–12PubMedCrossRef
29.
Zurück zum Zitat Boldt J, Jaun N, Kumle B, et al. Economic considerations of the use of new anaesthetics: a comparison of propofol, sevoflurane, desflurane, and isoflurane. Anesth Analg 1998; 86: 504–9PubMed Boldt J, Jaun N, Kumle B, et al. Economic considerations of the use of new anaesthetics: a comparison of propofol, sevoflurane, desflurane, and isoflurane. Anesth Analg 1998; 86: 504–9PubMed
31.
Zurück zum Zitat Philip DK, Mushlin PS, Manzi D, et al. Isoflurane versus propofol for maintenance of anaesthesia for ambulatory surgery: a comparison of costs and recovery profiles [abstract]. Anesthesiology 1992; 77: A44CrossRef Philip DK, Mushlin PS, Manzi D, et al. Isoflurane versus propofol for maintenance of anaesthesia for ambulatory surgery: a comparison of costs and recovery profiles [abstract]. Anesthesiology 1992; 77: A44CrossRef
32.
Zurück zum Zitat Kantor G. The Cost Of Desflurane And Propofol Anaesthesia [Letter]. Anesth Analg 1993; 76: 1172PubMedCrossRef Kantor G. The Cost Of Desflurane And Propofol Anaesthesia [Letter]. Anesth Analg 1993; 76: 1172PubMedCrossRef
Metadaten
Titel
Low-Flow Anaesthesia
Does it have Potential Pharmacoeconomic Consequences?
verfasst von
Dr Stefan Suttner
Joachim Boldt
Publikationsdatum
01.06.2000
Verlag
Springer International Publishing
Erschienen in
PharmacoEconomics / Ausgabe 6/2000
Print ISSN: 1170-7690
Elektronische ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200017060-00004

Weitere Artikel der Ausgabe 6/2000

PharmacoEconomics 6/2000 Zur Ausgabe

Current Opinion

Disease Management