If the Price is Right? Cost Analysis of Propofol Infusions and Sevoflurane Anaesthesia in Endoscopic Cases

Lachlan J. Gan1, *, Gavin Sullivan1, 2
1 Department of Anaesthesia, Belmont District Hospital, Belmont NSW 2298, Australia
2 Department of Anaesthesia, John Hunter Hospital, New Lambton Heights NSW 2305, Australia

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© 2021 Gan & Sullivan.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Anaesthesia, Belmont District Hospital, Belmont NSW 2298, Australia 305; E-mail: Lachlan.gan@health.nsw.gov.au


The environmental superiority of Total Intravenous Anaesthesia (TIVA) compared to inhaled agents has been recognised by ANZCA in a 2019 statement. Yet what about cost? Little current data has been published on this topic. We conducted a cost analysis and audit of propofol use in 71 endoscopy cases (colonoscopy/gastroscopy), taking into account the cost of adjuncts (syringes, tubing, and discarded propofol). We then compared these to calculated costs of the same cases performed with sevoflurane anaesthesia. In terms of the agent, propofol was 35% cheaper, costing $1.60 for an average endoscopy compared to a sevoflurane cost of $2.46. Including the cost of adjuncts (including a laryngeal mask airway for sevoflurane anaesthesia), endoscopy cases with propofol infusions were 80% cheaper than the same case performed under sevoflurane general anaesthesia ($3.08 vs $15.48). Although pricing may vary from hospital to hospital, our data suggests choosing propofol costs less in endoscopy.