Comparison of economic effectiveness of desflurane and sevoflurane in ENT surgery

Purpose . To determine the clinical and economic effectiveness of using desflurane and sevoflurane as components of general balanced anesthesia when performing ENT surgeries in children. Methods . 132 cases of general anesthesia were analyzed during adeno- and/or tonsillotomy. The mean age of patients was 6.2±2.8 years. The average duration of anesthesia was 44.1±13.3 min. Direct medical costs, cost efficiency and budgetary impact were analyzed based on the weighted average prices in 2018. Results . In adeno- or tonsillotomy of mid-duration in children the cost of anesthesia support was 483.31 RUB for desflurane, and 283.48 RUB for sevoflurane. The expenditure difference amounted to 199.83 in favor of sevoflurane. Changing from desflurane to sevoflurane in 1,000 patients under 18 years old who require inhalation anesthesia will be accompanied by cost saving in the amount of 199,830 RUB. When the anesthetic concentration is changed, sevoflurane is also a less expensive technology in patients aged 1–3, 3–5 and 5–12 years old. While using the minimum recommended flows of fresh gas, the cost of anesthesia support will constitute 295.3 RUB for desflurane and 173.69 RUB for sevoflurane with the difference in favor of sevoflurane being 121,61 RUB for 44.1-min surgery with 3-min initial narcosis. Conclusion . Use of sevoflurane as a component of general combined balanced anesthesia in adeno- and/or tonsillotomy in children is more cost-efficient as compared to desflurane.