• Timea Bocskai, Csaba Loibl, Zoltan Vamos, Gabor Woth, Tihamer Molnar, Lajos Bogar, and Laszlo Lujber.
• Department of Anaesthesiology and Intensive Therapy, University of Pécs, Medical School, Ifjúság Str 13, Pécs, 7624, Hungary. timokeri@gmail.com.
• BMC Anesthesiol. 2018 Jul 28; 18 (1): 100.

BackgroundWe compared cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring, in the clinical setting of ear-nose-throat surgery.MethodsOne hundred twenty adult patients were randomized to four groups. In groups SEVO and SEVO+ anesthesia was maintained with sevoflurane, in group SEVO+ with additional bispectral index (BIS) and train-of-four (TOF) monitoring. In groups PROP and PROP+ anesthesia was maintained with propofol, in group PROP+ with additional BIS and TOF monitoring.ResultsTotal cost of anesthesia per hour was greater in group SEVO+ compared to SEVO [€ 19.95(8.53) vs. 12.15(5.32), p <  0.001], and in group PROP+ compared to PROP (€ 22.11(8.08) vs. 13.23(4.23), p <  0.001]. Time to extubation was shorter in group SEVO+ compared to SEVO [11.1(4.7) vs. 14.5(3.9) min, p = 0.002], and in PROP+ compared to PROP [12.6(5.4) vs. 15.2(4.7) min, p <  0.001]. Postoperatively, arterial blood pressure returned to its initial values sooner in groups SEVO+ and PROP+.ConclusionsOur study demonstrated that the use of BIS and TOF monitoring decreased the total cost of anesthesia drugs and hastened postoperative recovery. However, in our circumstances, these were associated with higher disposables costs. Detailed cost analysis and further investigations are needed to identify patient populations who would benefit most from additional monitoring.Trial RegistrationClinicalTrials.gov, NCT02920749 . Retrospectively registered (date of registration September 2016).

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