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

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Summary
Cumulative %
Positive net benefit
Recruitment
The overall recruitment rate was 75%, and 25
patients were withdrawn, providing 322 patients in
the study. Nineteen per cent of patients were lost
to follow-up 7 days after discharge.
Clinical outcomes
• Children were significantly more sick with sevoflurane/sevoflurane
than with propofol/halothane.
• No gender difference was found in terms of
the rate of PONV. An additional risk factor
associated with PONV is agitation in recovery.
• The overall overnight admission rate was
only 1.2%.
Resource use
• The length of hospital stay was not different
between randomisation arms, but variable costs
and total costs were significantly higher in the
sevoflurane/sevoflurane arm.
• There were extremely low postdischarge costs to
both the NHS and the parents, demonstrating
that day-surgery discharge policies were
clinically appropriate.
© Queen’s Printer and Controller of HMSO 2002. All rights reserved.
Health Technology Assessment 2002; Vol. 6: No. 30
Positive net cost
–1500 –1300 –1100 –900 –700 –500 –300 –100 0 100 300 500 700
Net cost (£)
FIGURE 27 The cumulative percentage of the net cost for each anaesthetic regimen in the paediatric study (–––, sevoflurane/
sevoflurane; - - -, propofol/halothane)
Patient preferences and CV
• Parents whose children had not had the mask
(sevoflurane) before did not want it in the
future. Parents whose children had not had the
injection (propofol) before did not want it in
the future. On the whole, parents were happy
with the technique their children received.
• Those parents who would choose the same
induction method in the future as that which
their child had received tended to give higher
CVs than those who chose the alternative
method for induction, but the differences
were not statistically significant.
• Parents did not give higher CVs for avoiding
PONV if their child had received sevoflurane/
sevoflurane. Parents gave higher CVs for their
children to avoid PONV than did the adult
patients to avoid PONV themselves.
• There was no significant difference in CVs
for maintenance anaesthesia between those
parents whose children had and had not
experienced PONV.
Cost-effectiveness analysis
Propofol/halothane was the most effective
and least costly (£3.50 per patient, rate of
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