The case for abandonment of explosive anesthetic agents

The use of inflammable anesthetics in the United States has been debated widely over the past several years. Those in favor of continued use of these agents argue for educational use, professional freedom, pharmacologic safety, and the need to retain an option. Those in favor of a ban on such agents cite the lack of demonstrated pharmacologic advantage, diminishing physician expertise, risk of fire, and cost. The use of inflammable anesthetics has declined markedly over the past 15 years; in 1978, only 15 per cent of American hospitals were reportedly using them. However, we estimate that the use of inflammable anesthetics adds approximately $9.4 million to the annual cost of surgical care. As their use declines further, the cost per patient increases because most of the costs are fixed. We advocate a ban on inflammable anesthetics. Without definitive action on the part of policy makers, the use of these agents is likely to continue at a very low, and hence a relatively expensive, rate.