Sevoflurane induction procedure: cost comparison between fixed 8% versus incremental techniques in pediatric patients

This study compared 2 well-accepted and safe methods of pediatric inhalation induction using sevoflurane. Incremental and fixed 8% induction methods were evaluated for economic outcomes by comparing the amount of liquid sevoflurane consumed. We also tried to establish the relation between cost of induction and demographic parameters in both groups. One hundred pediatric patients scheduled for ophthalmologic examination under anesthesia were randomly divided into 2 equal groups. The amount of sevoflurane consumed in both groups was computed using the Dion method. Although the time to loss of consciousness was significantly lower using the 8% method (75.98 vs 135 seconds), the liquid sevoflurane consumption using the incremental method (2.25 mL) was almost half that of the fixed 8% method (4.46 mL). The overall procedural cost of induction (loss of consciousness plus intravenous cannulation and insertion of a laryngeal mask airway) was also almost double using the fixed 8% method. Use of the incremental method preferably over the fixed 8% method could save almost $18 US for each procedure. The volume of sevoflurane consumed during anesthesia induction was found to be independent of age, weight, or sex of pediatric patients. Both induction methods proved to be equally safe and acceptable to the patients.