Abstract:
UNLABELLED:With the development of new computer-assisted target-controlled infusion (TCI) systems and the availability of short-acting anesthetics, total IV anesthesia (TIVA) has become increasingly popular. The aim of this study was to compare costs of TCI-based anesthesia with two standard anesthesia regimens. Sixty patients undergoing elective laparoscopic cholecystectomy were randomly divided into three groups. Group 1 (TIVA/TCI) received TIVA using a propofol-based TCI system and continuous administration of remifentanil; Group 2 (isoflurane) underwent inhaled anesthesia with isoflurane, fentanyl, and N2O; Group 3 (standard propofol) received fentanyl and N2O and a continuous infusion of propofol using a standard delivery system. Maintenance doses for anesthetics were adjusted according to the patient's need. Isoflurane consumption was measured by weighing the vaporizer by using a precision weighing machine. Duration of surgery and of anesthesia was similar in the three groups. Time from stopping administration of anesthetics until tracheal extubation (6+/-2 min) and stay in the postanesthesia care unit (PACU; 70+/-12 min) were shorter in Group 1 than in the Groups 2 (15+/-3 and 87+/-13 min, respectively) and 3 (10+/-4 and 81+/-14 min, respectively) (P < 0.05). Episodes of postoperative nausea and vomiting in the PACU and on the surgical ward were less common in Group 1 than in the other two groups. Intraoperative costs were higher in Group 1 ($62.19/patient; $0.55/min of anesthesia) than in Groups 2 ($16.97/patient; $0.13/min of anesthesia) and 3 ($34.68/patient; $0.32/min of anesthesia). Cost for discarded anesthetic drugs accounted for almost 18% of total intraoperative costs in Group 1. We conclude that TIVA/TCI anesthesia using propofol/remifentanil was associated with the highest intraoperative costs but the fewest postoperative side effects. An overall cost-effectiveness analysis of new anesthetic regimens must balance the direct cost of anesthetics and beneficial effects leading to improved patients' comfort. IMPLICATIONS:In today's climate of cost-consciousness, careful economic evaluation of new anesthetic regimens is necessary. A target-controlled infusion (TCI)-based total IV anesthesia (TIVA) regimen using propofol and remifentanil was compared with a standard propofol anesthesia regimen and an inhaled anesthetic technique using isoflurane. Target-controlled infusion/total IV anesthesia was associated with the largest intraoperative costs but allowed the most rapid recovery from anesthesia, was associated with fewest postoperative side effects, and permitted earlier discharge from the postanesthesia care unit.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Suttner S,Boldt J,Schmidt C,Piper S,Kumle Bdoi
10.1097/00000539-199901000-00015subject
Has Abstractpub_date
1999-01-01 00:00:00pages
77-82issue
1eissn
0003-2999issn
1526-7598journal_volume
88pub_type
临床试验,杂志文章,随机对照试验,收录出版abstract::Alkalinized bupivacaine 0.75% (pH 6.8) and a mixture (1:1) of bupivacaine 0.75% and lidocaine 2%, both with hyaluronidase, were compared in regional ophthalmic anesthesia for day-case cataract surgery. Eighty-two patients were randomized into two groups (n = 39 and 43) to receive one of the two solutions in a double-b...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199407000-00008
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:In the present study, we examined the effects and mechanisms of the Chinese herb resveratrol on attenuation of morphine tolerance in rats. METHODS:Male Wistar rats were implanted with 2 intrathecal catheters; one catheter was connected to a mini-osmotic pump, used for either morphine (15 μg/h) or saline (1 ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31825da0fb
更新日期:2012-10-01 00:00:00
abstract:UNLABELLED:Animal studies have suggested that the temporal summation of nociceptive inputs might play a significant role in the development of central sensitization (i.e., hyperexcitability of central nociceptive neurons) and hyperalgesia via the activation of N-methyl-D-aspartate receptors. To further analyze these pr...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200002000-00031
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Aspirin-resistant platelet activation in whole blood is attributable to a transcellular pathway not detected by isolated platelet aggregometry. Aspirin resistance as defined by urinary thromboxane levels is associated with increased risk for myocardial infarction or cardiac death. Whole blood point-of-care a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e318277de06
更新日期:2013-02-01 00:00:00
abstract:UNLABELLED:Previous studies of samples from cranial meninges have created doubts about the existence of a virtual subdural space. We examined the ultrastructure of spinal meninges from three human cadavers immediately after death to see whether there is a virtual subdural space at this level. The arachnoid mater had tw...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200204000-00040
更新日期:2002-04-01 00:00:00
abstract::Preoperative use of angiotensin-converting enzyme (ACE) inhibitors is common and has been associated with hypotension at separation from cardiopulmonary bypass (CPB). This study prospectively examined the influence of chronic preoperative ACE inhibitor use and other perioperative factors on the incidence of vasoconstr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199503000-00007
更新日期:1995-03-01 00:00:00
abstract::This randomized double-blind study compared the hemodynamic and metabolic effects of pancuronium and vecuronium during treatment of shivering after cardiac surgery with hypothermic cardiopulmonary bypass. Thirty sedated and pain-free patients who shivered after cardiac surgery were treated with pancuronium (n = 15) or...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199409000-00012
更新日期:1994-09-01 00:00:00
abstract::Windup is a progressive increase in responses of nociceptive spinal cord neurons to repeated electrical C fiber stimulation. We hypothesized that isoflurane would depress windup at approximately the minimum alveolar anesthetic concentration (MAC) required to suppress purposeful movement in response to noxious stimulat...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000135635.32227.DA
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Anesthesiologists may contribute to postoperative infections by means of the transmission of blood and pathogens to the patient and the environment in the operating room (OR). Our primary aims were to determine whether contamination of the IV hub, the anesthesia work area, and the patient could be reduced af...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000000854
更新日期:2015-11-01 00:00:00
abstract:UNLABELLED:Using a MEDLINE-based analysis, we studied the national origin of articles published in important anesthesia, pain, critical care, and emergency medicine journals. All journals in English listed in the Science Citation Index (SCI) of Journal Citation Reports under the subheadings Anesthesiology (n = 17) and ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,收录出版
doi:10.1097/00000539-199905000-00038
更新日期:1999-05-01 00:00:00
abstract:UNLABELLED:We tested the hypothesis that an insulin infusion would effectively treat bupivacaine-induced cardiac depression in dogs. In 24 mongrel dogs anesthetized with pentobarbital (5 mgkg(-1)h(-1), IV), 0.5% bupivacaine was administrated at a rate of 0.5 mgkg(-1)min(-1) until the mixed venous oxygen saturation decr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200011000-00010
更新日期:2000-11-01 00:00:00
abstract::We evaluated risk of heart block after cardiopulmonary by-pass (CPB) in patients with normal conduction undergoing coronary artery bypass grafting who chronically received calcium-entry blockers, beta-blockers, or combined therapy. Before CPB, calcium-entry blockers alone produced an increase in P-R intervals but no c...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1984-05-01 00:00:00
abstract:BACKGROUND:Endoscopic retrograde cholangiopancreatography (ERCP) patients typically receive either tubeless anesthesia or general endotracheal anesthesia (GETA). Patients receiving propofol-based total intravenous anesthesia (TIVA) are at higher risk of sedation-related adverse events (SRAEs) than patients receiving GE...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005183
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Different drugs have been used to enhance postoperative neuraxial opioid analgesia and reduce adverse effects. METHODS:We randomized 60 patients into 2 groups to receive either 2 mL saline or 0.1 mg/kg dexamethasone IV before the administration of intrathecal anesthesia (15 mg and meperidine 15 mg). After s...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000257926.07491.55
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Perioperative beta-blockers are suggested to reduce cardiovascular mortality, myocardial-ischemia/infarction, and supraventricular arrhythmias after surgery. We reviewed the evidence regarding the effectiveness of perioperative beta-blockers for improving patient outcomes after cardiac and noncardiac surgery...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000247805.00342.21
更新日期:2007-01-01 00:00:00
abstract::Risk of wound infection is increased in morbidly obese surgical patients, in part because a major determinant of wound infection risk, tissue oxygenation, is marginal. Unlike in lean patients, supplemental inspired oxygen (Fio2) only slightly improves tissue oxygenation in obese patients. Mild hypercapnia improves tis...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000229715.71464.90
更新日期:2006-09-01 00:00:00
abstract::Descriptive statistics are specific methods basically used to calculate, describe, and summarize collected research data in a logical, meaningful, and efficient way. Descriptive statistics are reported numerically in the manuscript text and/or in its tables, or graphically in its figures. This basic statistical tutori...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002471
更新日期:2017-11-01 00:00:00
abstract::In the past, it was common practice to use a high tidal volume (VT) during intraoperative ventilation, because this reduced the need for high oxygen fractions to compensate for the ventilation-perfusion mismatches due to atelectasis in a time when it was uncommon to use positive end-expiratory pressure (PEEP) in the o...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000005187
更新日期:2020-12-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/01.ANE.0000147505.98565.AC
更新日期:2005-04-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199702000-00003
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:Variations in the butyrylcholinesterase (BCHE) gene can prolong neuromuscular block after the administration of the neuromuscular blocking drugs succinylcholine and mivacurium. The most frequent variations in the BCHE gene are the atypical (A) and Kalow (K) variants. We, therefore, developed a detection appr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000296455.31211.bd
更新日期:2008-01-01 00:00:00
abstract::Leakge of lymph following puncture of the right subclavian vein occurred in a patient, requiring a pacemaker catheter. The lymph drainage settled spontaneously after 4 days on remanipulation of the pacing wire. ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197801000-00027
更新日期:1978-01-01 00:00:00
abstract::As part of an oximetry research effort in which plethysmographic data were collected from moving patients, a wide variety of patient motion affecting pulse oximetry was observed and characterized by the clinical incidence, type, severity and duration of patient motion. 350 patients were observed for movement in clinic...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Many new mechanical ventilation modes are proposed without any clinical evaluation. "Dual-controlled" modes, such as AutoFlow™, are supposed to improve patient- ventilator interfacing and could lead to fewer alarms. We performed a long-term clinical evaluation of the efficacy and safety of AutoFlow during as...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3181f00015
更新日期:2010-10-01 00:00:00
abstract::The anesthetic effect of lidocaine was evaluated in rats by determining the change in anesthetic requirement of cyclopropane MAC that was produced by blood concentrations of lidocaine in the clinically useful range. A linear reduction in anesthetic requirement was produced with concentrations up to 1 mug/ml. Further i...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197611000-00016
更新日期:1976-11-01 00:00:00
abstract:BACKGROUND:We tested the hypothesis that hypothyroidism, as defined by thyroid-stimulating hormone (TSH) concentration, is associated with a severity-weighted composite of mortality and major cardiovascular and infectious complications after noncardiac surgery. METHODS:In this retrospective cohort study, we evaluated ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000805
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:The accurate measurement of oxygen consumption (VO2) and energy expenditure (EE) may be helpful to optimize the treatment of critically ill patients. However, current techniques are limited in their ability to accurately quantify these end points in infants due to a low VO2, low tidal volume, and rapid respi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000003308
更新日期:2018-07-01 00:00:00
abstract:UNLABELLED:Intraoperative recording of myogenic motor responses evoked by transcranial electrical stimulation (tcMEPs) is a method of assessing the integrity of the motor pathways during aortic surgery. To identify conditions for optimal spinal cord monitoring, we investigated the effects of manipulating the level of n...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-199901000-00005
更新日期:1999-01-01 00:00:00
abstract::Education is the fundamental process used to develop and maintain the professional skills of physicians. Medical students, residents, and fellows are expected to learn considerable amounts of information as they progress toward board certification. Established practitioners must continue to learn in an effort to remai...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000000890
更新日期:2015-12-01 00:00:00
abstract::In chloralose-anesthetized dogs the hypotensive and reflex cardiovascular responses to infusions of sodium nitroprusside were studied before and during halothane and enflurane, and before after divided doses of cryptenamine. The latter drug, a mixture of hypotensive veratrum alkaloids, lowers blood pressure reflexly b...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1980-12-01 00:00:00