Wydawnictwo medyczne Cornetis

Medical publisher

+48 71/ 792 80 77 sekretariat@cornetis.pl

Offer for publishers - CORPRESS SYSTEM


Title: Cost analysis of propofol and remifentanil analgosedation vs total intravenous anaesthesia for ambulatory colonoscopy

Robert Rudner, Przemysław Jałowiecki, Piotr Kawecki, Maciej Gonciarz, Aldona Mularczyk, Michał Petelenz
Original articles
Polish Gastroenterology
Start page:
Final page:
cost analysis, colonoscopy, total intravenous anaesthesia, analgosedation, remifentanil

Objectives: Comparison of costs of total intravenous anaesthesia and conscious analgosedation for ambulatory colonoscopy. Material and methods: Pharmacoeconomical analysis based on data received from prospective, controlled, ran-domised study in the group of 100 patients allowed for colonoscopies conducted in the out-patient's clinic, where 4-5 colonoscopies are performed daily. Patients in the F group (n=50) received single doses of fen-tanyl (2 ug/kg) and midazolam (0.05 mg/kg) and titrated doses of propofol in the way that bispectral index (BIS) is 60±10. Patients in the R group (n=50) received analgosedation by continuous infusion of remifentanil (0.2 ug/kg/min) and titrated doses of propofol to maintain the lll° of Ramsa^s sedation scalę. The costs of used medication and disposable equipment were calculated including their lowest, highest and ave-rage prices. We took into consideration the capital allowance of durable facilities. We excluded identical items for both groups. Results: No demographic differences were found among the groups and both groups were similar with re-spect to initial parameters and duration of colonoscopy (p>0.05). The lowest, highest and average costs were: in R group - 4.14 and 25.00 (12.80±4.54) PLN and in Fgroup - 9.39 and 38.63 (17.56±6.94) PLN, respectively (p<0.05). Conscious analgosedation was on average 4.76 PLN cheaper than total intraveno-us anaesthesia. Propofol tookthe greatest part in the costs (R: 47.2%, F: 72.93%). The use of 2.5 times cheaperingenuineformof thisdrug resulted in the same expense in both groups(p>0.05). Assuming atle-ast 1000 analgosedations per year, the cost of infusion pump use did not exceed 7% of the overall costs in the R group. Conclusions: 1. Analgosedation with remifentanil and propofol could be a cheaper method of providing a patient with comfort during colonoscopy compared to intravenous anaesthesia. 2. The usage of infusion pump does not significantly increase the costs of above described method of analgosedation when at least 4-5 colonoscopies a day are performed.