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Clinical safety and cost analysis of Sevoflurane and Isoflurane in surgical patients

Authors: EbrahimHazrati, Mohamad Reza Rafiei, Mohamad Afsahi and MasoudRamezani

Int J Med Res Health Sci.326-330 | pdf PDF Full Text

Determining the cost of volatile anesthetic agents is important to buffer the rising cost of healthcare by cost effective
use of these drugs. Herein, this paper presented a cost analysis of sevoflurane and isoflurane with considering their
effects on hemodynamic stability. In a randomized clinical trial, 52 ASA status I–II patients candidate for
aortobifemoral bypass surgery were assigned to receive low-flow sevoflurane anesthesia (n = 26) or low-flow
isoflurane (n = 26). Patients were monitored for assessment of hemodynamic parameters and the amount of gas
consumption and costs for each patient was also recorded. The mean cost of consumed gas in sevoflurane group
was 87807 ± 41261 Iranian rials (currency) and in isoflurane group was 144423 ± 69609 Iranian rials that was
considerably higher in isoflurane group (p < 0.001). In line with assessing cost of consumed gas, increased mean
arterial blood pressure (> 100 mmHg) was obtained in 80.8% in sevoflurane group and 84.6% in isoflurane group
after aortic clamping and also following removal of aortic clamp with no significant differences. Regarding changes
in heart rate in sevoflurane and isoflurane groups, after removal of aortic clamp, the overall prevalence of
bradycardia was higher in those who received isoflurane compared with another group (97.2% versus 26.8%),
while sevoflurane group experienced normal sinus rhythm more than that observed in isoflurane group (30.8%
versus 3.8%, p < 0.001). Considering both clinical safety and affordability, Sevoflurane is preferred to isoflurane as
anesthetics for surgical patients.

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