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Propofol-based versus fentanyl-isoflurane-based anesthesia for cardiac surgery
M C Engoren1, C Kraras, F Garzia
1Department of Anesthesiology, Saint Vincent Medical Center, Toledo, OH 43608, USA.
Objective:
To evaluate drug costs, time of mechanical ventilation, complications, and hospital length of stay comparing propofol-based with fentanyl-isoflurane-based anesthesia.
Design:
A prospective, randomized study.
Setting:
A university-affiliated, tertiary care community hospital.
Participants:
Seventy patients undergoing primary coronary artery bypass surgery.
Interventions:
Patients were randomized to either a low-dose fentanyl-isoflurane or a lower-dose fentanyl-isoflurane anesthetic supplemented with a continuous infusion of propofol.
Measurements And Main Results:
Fentanyl-isoflurane anesthesia was significantly less expensive ($50.03+/-$27.26 v $121.69+/-$31.40) for anesthesia drugs and ($58.08+/-$27.39 v $129.91+/-$31.52) for total drug costs. There was also a trend for patients in the fentanyl-isoflurane group to be extubated slightly sooner (388+/-202 v 449+/-252 min) and go home sooner (5.1+/-1.8 v 6.0+/-3.0 days).
Conclusion:
Fentanyl-isoflurane provides an inexpensive anesthetic that permits as prompt an extubation as propofol, thus conserving resources for other patients.