Cost-Effectiveness of Propofol (Diprivan) Versus Inhalational Anesthetics to Maintain General Anesthesia in Noncardiac Surgery in the United States
| Autor: | Tim Kampmeier, Abdul Jabbar Omar Alsaleh, Jenny Pham, Stefan Schraag, Martin Westphal, S. Rehberg |
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| Rok vydání: | 2021 |
| Předmět: |
Cost effectiveness
Cost-Benefit Analysis Anesthesia General law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans Hypnotics and Sedatives 030212 general & internal medicine Propofol Randomized Controlled Trials as Topic business.industry 030503 health policy & services Health Policy Public Health Environmental and Occupational Health Guideline Intravenous anesthesia General Surgery Anesthesia Anesthetics Inhalation Ambulatory medicine.symptom 0305 other medical science business Noncardiac surgery Postoperative nausea and vomiting medicine.drug |
| Zdroj: | Value in Health. 24:939-947 |
| ISSN: | 1098-3015 |
| Popis: | Objectives It is not known whether using propofol total intravenous anaesthesia (TIVA) to reduce incidence of postoperative nausea and vomiting (PONV) is cost-effective. We assessed the economic impact of propofol TIVA versus inhalational anesthesia in adult patients for ambulatory and inpatient procedures relevant to the US healthcare system. Methods Two models simulate individual patient pathways through inpatient and ambulatory surgery with propofol TIVA or inhalational anesthesia with economic inputs from studies on adult surgical US patients. Efficacy inputs were obtained from a meta-analysis of randomized controlled trials. Probabilistic and deterministic sensitivity analyses assessed the robustness of the model estimates. Results Lower PONV rate, shorter stay in the post-anesthesia care unit, and reduced need for rescue antiemetics offset the higher costs for anesthetics, analgesics, and muscle relaxants with propofol TIVA and reduced cost by 11.41 ± 10.73 USD per patient in the inpatient model and 11.25 ± 9.81 USD in the ambulatory patient model. Sensitivity analyses demonstrated strong robustness of the results. Conclusions Maintenance of general anesthesia with propofol was cost-saving compared to inhalational anesthesia in both inpatient and ambulatory surgical settings in the United States. These economic results support current guideline recommendations, which endorse propofol TIVA to reduce PONV risk and enhance postoperative recovery. |
| Databáze: | OpenAIRE |
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