Issn Print: 0265-0215

Publication Date: 2007/06/01


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Quantative EEG monitored anaesthesia; cost comparison of three anaesthetic techniques management: 3AP2-7

B. Berkel; Z. Alanoglu; Y. Ates; O. SelviCan; F. Tuzuner

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Background and Goal of Study: Monitoring the central nervous system effects of anaesthesia in an objective, reliable fashion has been an ultimate goal (1). Objective criteria for the depth of anaesthesia are the most challenging and missing part for cost and recovery studies (2). The purpose of this study was to compare quantitative EEG (QEEG), haemodynamic changes and cost analysis of a propofol/remifentanil (TIVA), desflurane, sevoflurane anaesthesia in major abdominal surgery.
Material and Methods: With IRB approval and written informed consent 60 ASA I-III patients undergoing elective major abdominal surgery were allocated randomly to groups to receive propofol/remifentanil (Group P n = 20), desflurane (Group D n = 20) or sevoflurane (Group S n = 20) based anaesthesia. ECG, NIBP, SpO2, oesophagus temperature, TOF, QEEG monitoring were done and data were collected at before induction, at induction, at intubation; during anaesthesia management, before and after skin suturing and at complete recovery. The minute cost of anaesthesia agent was calculated. Area under (AUC) haemodynamic variables, QEEG values and time curves were calculated and assessed with one way ANOVA. Repeated measures for ANOVA and Chi-square tests were also used and p < 0.05 was considered as significant. Values expressed as mean and SD.
Results and Discussion: The area under haemodynamic variables vs time curves were higher in Group P compared to other groups (p < 0.05). Similarly, SEF 95 and alpha wave value were higher and values of power and theta waves were lower in Group P compared to other groups during noxious stimuli (p < 0,05). Calculated minute cost of anaesthetic agent was lower in Group S (0,13 ± 0,02 Euro) then both Group D (0,17 ± 0,02 Euro, p = 0.001) and Group P (0,16 ± 0,04 Euro, p = 0.015). The recovery and postoperative variables were similar among groups.
Conclusions: QEEG demonstrated lighter plains of anaesthesia with propofol/ remifentanil based maintenance; however the use of sevoflurane as the anaesthetic agent not only provided efficient anaesthesia depth, but also the cheapest one.
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