Abstract

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

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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