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AMBULATORY ANESTHESIA

Selective Spinal Anesthesia Versus Desflurane Anesthesia in Short Duration Outpatient Gynecological Laparoscopy: A Pharmacoeconomic Comparison

Department of Anesthesia, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada

Address correspondence and reprint requests to Dr. Himat Vaghadia, Department of Anesthesia, JPP 2449, Vancouver General Hospital, 855 West 12th Avenue, Vancouver, BC, Canada V5Z 1M9. Address e-mail to hvaghadi{at}vanhosp.bc.ca

We compared the cost and effectiveness of selective spinal anesthesia (SSA) with a desflurane-based general anesthetic (DES) for outpatient gynecological laparoscopy. A prospective analysis was undertaken of 10 patients randomized to receive SSA and compared with 10 patients randomized to receive DES. The groups were well matched in their demographic characteristics. The mean cost (in 2000 Canadian dollar values) of anesthesia supplies, drugs, and nursing for the SSA group of $62.31 was less than that for the DES group of $92.31 (P < 0.01). Recovery costs of both groups were similar. Time to administer anesthesia and time spent in the postanesthetic care unit were also similar. Postoperative analgesia was required by 50% of the DES group but in no patient receiving SSA (P < 0.01). SSA is a cost-effective alternative to DES in these patients.

IMPLICATIONS: Small-dose spinal anesthesia is an effective alternative to a desflurane general anesthetic in terms of cost and recovery profiles in ambulatory gynecological laparoscopy.

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