Propofol-based versus fentanyl-isoflurane-based anesthesia for cardiac surgery

Abstract

Objective: To evaluate drug costs, time of mechanical ventilation, complications, and hospital length of stay comparing propofol-based with fentanyl-isoflurane-based anesthesia.

Design: A prospective, randomized study.

Setting: A university-affiliated, tertiary care community hospital.

Participants: Seventy patients undergoing primary coronary artery bypass surgery.

Interventions: Patients were randomized to either a low-dose fentanyl-isoflurane or a lower-dose fentanyl-isoflurane anesthetic supplemented with a continuous infusion of propofol.

Measurements and main results: Fentanyl-isoflurane anesthesia was significantly less expensive ($50.03+/-$27.26 v $121.69+/-$31.40) for anesthesia drugs and ($58.08+/-$27.39 v $129.91+/-$31.52) for total drug costs. There was also a trend for patients in the fentanyl-isoflurane group to be extubated slightly sooner (388+/-202 v 449+/-252 min) and go home sooner (5.1+/-1.8 v 6.0+/-3.0 days).

Conclusion: Fentanyl-isoflurane provides an inexpensive anesthetic that permits as prompt an extubation as propofol, thus conserving resources for other patients.