Aanesthetic Agents for Day Surgery - NIHR Health Technology ...

500
400
300
200
100
0
–100
–200
–300
–400
–500
Net cost (£)
Propofol/
propofol
Propofol/
isoflurane
Propofol/
sevoflurane
Anaesthetic regimen
FIGURE 16 The net cost for each anaesthetic regimen
(limit 5% and 95% percentiles) in the adult study
100
90
80
70
60
50
40
30
20
10
0
Cumulative %
Sevoflurane/
sevoflurane
Health Technology Assessment 2002; Vol. 6: No. 30
Summary
Recruitment
The overall recruitment rate was 73%, and
95 patients were withdrawn, providing 1063
patients for the study. Fifteen per cent of patients
were lost to follow-up 7 days after discharge.
Clinical outcomes
Adults had a statistically significantly higher incidence
of PONV with sevoflurane/sevoflurane than
with propofol/propofol. Sevoflurane/sevoflurane
was significantly different from propofol/volatile,
but the difference between propofol/propofol
and propofol/volatile was not significant.
The gender difference shown in previous studies
was confirmed. The difference disappears with
age and there was no gender difference in the
paediatric study, and thus a premenopausal/
hormonal risk is implied. Additional risk factors
associated with PONV are gynaecological surgery,
agitation in recovery and duration of surgery.
The overall overnight admission rate was nearly
9%, which is quite high. However, this was due in
part to the urology patients. In these patients high
admission rates can be justified in some circumstances,
as the patient is booked as a day-case but
FIGURE 17 The cumulative percentage of the net cost for each anaesthetic regimen in the adult study (– . – .,propofol/propofol;
.....,propofol/isoflurane; –––, propofol/sevoflurane; – – –, sevoflurane/sevoflurane)
© Queen’s Printer and Controller of HMSO 2002. All rights reserved.
Positive net benefit Positive net cost
–2000 –1600 –1200 –800 –400 0 400 800
Net cost (£)
65