مجله دانشکده پزشکی اصفهان (Oct 2014)
Comparative Evaluation of Cost and Benefit of Two High and Low End-Inspiratory Carbon Dioxide Pulmonary Mechanical Ventilation during General Anesthesia
Abstract
Background: During pulmonary mechanical ventilation in general anesthesia, end tidal carbon dioxide concentration should be preserved in the range of 0-1 mmHg. It seems that pulmonary ventilation with high end-inspiratory carbon dioxide concentration prevents loss of fresh inspiratory gases and inhalation anesthetic drugs and is affordable. This study was designed to evaluate the cost and benefit of two different anesthesia methods, high and low end-inspiratory carbon dioxide concentration. Methods: In this prospective, randomized and single-blind clinical trial, patients were studied in two groups of 34. Patients were ventilated with high and low end-inspiratory carbon dioxide concentrations in study and blank groups. Objectives were end- inspiratory and expiratory carbon dioxide concentration, amount of fresh inspiratory gas, and isoflurane and soda lime consumption and their costs. Findings: The amount of fresh inspiratory gas consumption and its costs over the duration of surgery was significantly lower in the test group (P < 0.001). The amount and cost of consumed isoflurane during surgery was significantly lower in the test group, too (P < 0.001) Conclusion: In general anesthesia, pulmonary mechanical ventilation with high end-inspiratory carbon dioxide concentration lead to lower consumption of fresh inspiratory gases, inhaled anesthetics and soda lime. Ultimately, lower costs are imposed to patients and healthcare system.
