Cost analysis of xenon anesthesia: a comparison with nitrous oxide-isoflurane and nitrous oxide-sevoflurane...

To determine the cost of xenon (Xe) anesthesia in relation to the anesthetic duration by conducting a cost analysis of this relatively expensive inhaled anesthetic.

Cost analysis based on the literature on Xe anesthesia.

Anesthetic simulation based on data obtained in the operating rooms at a university hospital.

A 40-year-old, ASA physical status I adult patient model weighing 70 kg, undergoing elective minor surgery with endotracheal intubation and mechanical ventilation.

Anesthesia was given in the following four techniques: 1) closed-circuit technique with Xe; 2) closed-circuit technique with nitrous oxide (N2O)-isoflurane; 3) semi-closed technique with N2O-isoflurane; and 4) semi-closed technique with N2O-sevoflurane.

Cost of each anesthetic technique was compared in U.S. dollars. The cost of Xe anesthesia was consistently higher than that of N2O-isoflurane or N2O-sevoflurane (for 240-min anesthesia; $356 with Xe, $52 with closed-circuit N2O-isoflurane, $94 with semi-closed N2O-isoflurane, and $84 with semi-closed N2O-sevoflurane). The major cost of Xe anesthesia was a result of the cost of priming and flushing; the cost of Xe used for its anesthetic effects was comparable with the other semi-closed techniques after 240 minutes.

For Xe to be widely used in routine anesthesia, the methods of minimizing the amount of Xe necessary for priming and flushing must be developed.