Study of direct variable anesthesia costs in the dilatation and curettage patient

This retrospective study was designed to compare the cost of anesthesia in three different groups of patients who received general anesthesia for a diagnostic dilatation and curettage procedure. The analysis included 194 patients, ASA physical status I, II, or III. All patients were outpatients with similar body mass index and age. The three groups were thiopental/isoflurane (n = 13), propofol/isoflurane (n = 126), and propofol/desflurane (n = 55). Anesthesia drugs, volatile agents, personnel costs, and type of providers were included in the cost comparison. The cost of supplies, inhalation agents, and drugs for the thiopental/isoflurane group were significantly different (P < .001) than the other two groups. The mean +/- SD thiopental/isoflurane combination was $7.00 +/- $2.74, whereas, the mean +/- SD cost of the propofol/isoflurane and propofol/desflurane groups was $12.73 +/- $3.57 and $14.40 +/- $5.05, respectively. The mean +/- SD cost of all three anesthetic drugs/volatile agents/endotracheal tube groups was $12.85 +/- $4.35. No statistically significant differences between the three groups were found in postanesthesia care unit (PACU) drug costs, anesthesia personnel cost, total direct anesthesia costs, or length of stay. The incidence of antiemetic administration intraoperatively and in PACU was significantly different (P < .001) between the thiopental/isoflurane group and the other groups. The thiopental/isoflurane group did not receive any antiemetics in either area, whereas the propofol groups received antiemetics 12.7% of the time. The three anesthesia providers, Certified Registered Nurse Anesthetists, student registered nurse anesthetists (SRNA), and anesthesia residents were reviewed looking at anesthesia supply cost, personnel cost, and total direct anesthesia costs. No statistically significant differences were found between the groups. We conclude that an anesthetic using thiopental/isoflurane is more cost-effective than propofol/desflurane or propofol/isoflurane anesthetics and the postoperative length of stay is no different for the three anesthetic approaches.