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Title: Financial and environmental costs of manual versus automated control of end-tidal gas concentrations.
Austin Authors: Tay, S;Weinberg, Laurence ;Peyton, Philip J ;Story, David A ;Briedis, J
Affiliation: Department of Anaesthesia, Austin Hospital, Melbourne, Victoria, Australia
Issue Date: 1-Jan-2013
Publication information: Anaesthesia and Intensive Care; 41(1): 95-101
Abstract: Emerging technologies that reduce the economic and environmental costs of anaesthesia have had limited assessment. We hypothesised that automated control of end-tidal gases, a new feature in anaesthesia machines, will consistently reduce volatile agent consumption cost and greenhouse gas emissions. As part of the planned replacement of anaesthesia machines in a tertiary hospital, we performed a prospective before and after study comparing the cost and greenhouse gas emissions of isoflurane, sevoflurane and desflurane when using manual versus automated control of end-tidal gases. We analysed 3675 general anaesthesia cases with inhalational agents: 1865 using manual control and 1810 using automated control. Volatile agent cost was $18.87/hour using manual control and $13.82/hour using automated control: mean decrease $5.05/hour (95% confidence interval: $0.88-9.22/hour, P=0.0243). The 100-year global warming potential decreased from 23.2 kg/hour of carbon dioxide equivalents to 13.0 kg/hour: mean decrease 10.2 kg/hour (95% confidence interval: 2.7-17.7 kg/hour, P=0.0179). Automated control reduced costs by 27%. Greenhouse gas emissions decreased by 44%, a greater than expected decrease facilitated by a proportional reduction in desflurane use. Automated control of end-tidal gases increases participation in low flow anaesthesia with economic and environmental benefits.
Gov't Doc #: 23362897
Type: Journal Article
Subjects: Adolescent
Aged, 80 and over
Anesthesia, General.economics.instrumentation
Anesthetics, Inhalation.administration & dosage.economics
Carbon Dioxide.chemistry
Child, Preschool
Drug Costs
Global Warming
Greenhouse Effect.economics.prevention & control
Hospitals, University
Isoflurane.administration & dosage.analogs & derivatives.economics
Methyl Ethers.administration & dosage.economics
Middle Aged
Prospective Studies
Young Adult
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