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Anesthesia & Clinical Research

Anesthesia & Clinical Research
Open Access

ISSN: 2155-6148

+44 1223 790975

Abstract

Cost Containment of Inhaled Anesthetic Agents in Pediatric Anesthesia: How Much Does Reducing the Fresh Gas Flow Matter?

Jason Bryant and Joseph Tobias

Introduction: Techniques of cost containment remain important in the practice of medicine. One strategy to reduce the consumption of inhaled anesthetic agents is to use lower fresh gas flows (FGFs). The purpose of the current study is to evaluate various FGFs to determine the most effective means of conserving anesthetic agents and limiting costs.
Methods: Volatile anesthetic agent use and cost were determined using two different techniques. First by weighing the bottles containing the anesthetic agent before and after each case and secondly by measuring the amount of agent use based on Dion’s equation. The latter is calculated as PFTMC/2412d using vaporizer concentration (P), fresh gas flow in liters per minute (F), time in minutes (T), molecular weight (M), cost in dollars/mL (C), and density in g/mL (d). Patients were divided into two groups. In the control group, patients were observed and data recorded without suggestions for FGF, gas percentage, and the specific gas used. In the intervention group, there was a specific protocol for FGF, gas percentage, and the gas used. Six cost quantitative variables and four patient quantitative variables were obtained.
Results and Discussion: The cohort for the study included 101 patients. There were 50 patients in the observational group and 51 in the intervention group. All cost measures were lower in the intervention (low flow) group than the control group. The average cost was 68.3-78.0% lower depending on the specific cost measure used.
Conclusion: There were cost savings in both measured and calculated gas use when implementing a protocol for low fresh gas flows with a cost reduction of 68.3-78.0%. The two most significant changes that can improve cost containment for volatile anesthetic agent use are decreasing FGF rates and switching to isoflurane after anesthetic induction.

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