Tuna ERİNÇLER, Nurettin LÜLECİ, idil TEKİN, Remziye GÜL, İsmet TOPÇU, Ahmet TUTAN

Total intravenöz anestezi (TİVA) ile izofloran anestezisinin maliyet açısından karşılaştırılması

Amaç: Bu çalışmada TİVA (Total intravenöz anestezi)’da kullanılan propofolün maliyet açısından izofloran ile karşılaştırılması amaçlanmıştır. Yöntem: Parsiyel tiroidektomi (n=15) ve laparoskopik kolesistektomi (n=15) yapılan 30 hasta 10’ar kişilik üç gruba rasgele ayrıldı ve 1. gruba propofol+fentanil, 2. gruba standart izofloran, 3. gruba düşük akımlı sistemde (taze gaz girişi 2 L/dak) izofloran anestezisi uygulandı. Ventilasyon izofloran grubu hastalarda % 60 N20+02 ile yapıldı. Kas gevşetici olarak bütün olgularda vekuronyum kullanıldı. Harcanan izofloranın hacmi ölçülerek maliyeti hesaplandı. Bulgular: Propofol hastalarının derlenme odasında kalış süresi, izofloran alanlardan daha kısa; verilen analjezik ve antiemetiklerin maliyeti de daha düşüktü. TİVA ile yüksek ve düşük akımlı izofloran gruplarında hasta başına maliyet farklı bulundu (sırasıyla 9 557 950, 12 045 400 ve 7 699 500 TL). Sonuç: TİVA sanıldığı kadar pahalı olmayıp, düşük gaz akımlı sistemden daha emniyetli olması nedeniyle tercih edilebilir.

A cost comparison between total intravenous and isoflurane anaesthesia

Objective: In this study it was aimed to compare cost differences in propofol anaethesia and isoflurane. Methods: Thirty patients undergoing either thyroidectomy (n=15) or laparoscopic cholecystectomy (n=15) were randomly divided into 3 groups of 10 patients. In group I propofol and fentanyl, in group II isoflurane (standart isoflurane anaesthesia) and in group III isoflurane using a low flow system (fresh gas flow 2 L/min) were used for anaesthesia. Patients in the isoflurane groups were ventilated using 60% N20 in oxygen. Vecuronium was used in all cases for muscle relaxation. Isoflurane consumption was calculated by measuring the isoflurane volume. Results: Demographic data and time of administration of the anaesthetics were similar in the three groups. Propofol patients stayed significantly shorter than isoflurane patients in the postanaesthetic care unit (PACU). Costs of additional drugs (antiemetics, analgesics) in the PACU were least in the propofol patients. Costs were different between the TIVA ( 9 557 950 TL/patient) and standart isoflurane (12 045 400 TL/patient) groups. Patients in group III showed the lowest overall costs (7 699 500 TL/patient). Conclusion: TIVA is not so expensive and is preferable because of being safer than low-flow inhalation anaesthesia.

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