Servicios Personalizados
Revista
Articulo
Indicadores
Citado por SciELO
Accesos
Links relacionados
Citado por Google
Similares en SciELO
Similares en Google
Compartir
Colombian Journal of Anestesiology
versión impresa ISSN 0120-3347versión On-line ISSN 2256-2087
Resumen
CASAS-ARROYAVE, Fabián David. Total intravenous anesthesia vs inhalational anesthesia in patients undergoing surgery under general anesthesia. Cost-minimization study. Rev. colomb. anestesiol. [online]. 2022, vol.50, n.3, e202. Epub 22-Jul-2022. ISSN 0120-3347. https://doi.org/10.5554/22562087.e1023.
Introduction:
The methods most frequently used at the present time in Colombia for the administration of general anesthesia are based on halogenated and intravenous drugs. However, in view of the lack of differential clinical outcomes, the existence of cost variations between the two is not clear.
Objective:
To determine the expected cost of the use of both techniques in patients taken to surgery, within the framework of the Colombian national health system.
Methods:
A cost minimization study was carried out using the decision tree as the analytical model. A time frame of 6 postoperative hours was used as the assumption. Only direct healthcare-related costs were included using a case study approach. An econometric model was used based on the frequency with which each technology is applied and the type of drug used, and a deterministic and probabilistic sensitivity analysis was performed.
Results:
For the case study, total intravenous anesthesia (TIVA) is more costly than the inhalational technique, with an incremental cost of $102,718 per patient. The deterministic analysis shows that both the incidence of postoperative nausea and vomiting (PONV) as well as the use of target controlled infusion (TCI) techniques are the main cost determinants. The probabilistic analysis shows that the cost difference can even be nil in more than 50% of the simulated settings, when the difference in the risk of PONV is higher.
Conclusions:
Although the total intravenous technique can be more costly than the inhalational technique, this difference is offset by a lower cost of the postanesthesia care unit, given the lower risk of postoperative nausea and vomiting.
Palabras clave : Total endovenous anesthesia; Halogenated-based anesthesia; Cost-minimization; Postoperative nausea; Postoperative vomiting; Anesthesiology.