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British Journal of Anaesthesia, 2001, Vol. 87, No. 4 559-563
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Measuring the costs of inhaled anaesthetics{dagger}

G. G. Lockwood1 and D. C. White2

1Department of Anaesthesia, Imperial College School of Medicine, Hammersmith Hospital, London W12 0HS, UK. 2Northwick Park Hospital, London, UK*Corresponding author

{dagger} Part of this work was presented to the Plymouth meeting of the Anaesthetic Research Society, July 1999, and an abstract has appeared in the proceedings of that meeting (Br J Anaesth 1999; 83: 524P).

The cost of inhalation anaesthesia has received considerable study and is undoubtedly reduced by the use of low fresh gas flows. However, comparison between anaesthetics of the economies achievable has only been made by computer modelling. We have computed anaesthetic usage for MAC-equivalent anaesthesia with isoflurane, desflurane, and sevoflurane in closed and open breathing systems. We have compared these data with those derived during clinical anaesthesia administered using a computer-controlled closed system that measures anaesthetic usage and inspired concentrations. The inspired concentrations allow the usage that would have occurred in an open system to be calculated. Our computed predictions lie within the 95% confidence intervals of the measured data. Using prices current in our institution, sevoflurane and desflurane would cost approximately twice as much as isoflurane in open systems but only about 50% more than isoflurane in closed systems. Thus computer predictions have been validated by patient measurements and the cost saving achieved by reducing the fresh gas flow is greater with less soluble anaesthetics.

Br J Anaesth 2001; 87: 559–63


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