Cost-effective anaesthesia for outpatient arthroscopic knee surgery: spinal, desflurane, isoflurane or propofol anaesthesia?

Spinal anaesthesia (SA) is widely used in day surgery because it is easy and cheap. But how cheap is SA really, when compared to modern general anaesthesia with short-acting agents? The aim of this study was to compare SA to three modes of general anaesthesia in terms of the total costs of anaesthesia during outpatient knee arthroscopy (KA). There were 173 patients scheduled for elective KA randomised to receive SA with lidocaine, propofol infusion (PA), isoflurane (IA) or desflurane (DA) inhalation anaesthesia. The time spent in the operation theatre (OT) and the time to reach home readiness after postoperative care in the recovery unit (RU) were measured. The material and salary costs for the different anaesthesias were calculated. The total costs for IA and DA were significantly lower (PB0.05) than those for SA or PA. Inhalation anaesthesia, with either isoflurane or desflurane, is more cost-effective than SA or PA in elective ambulatory KA. © 2000 Elsevier Science B.V. All rights reserved.