A cost comparison of spontaneously ventilated patients: the universal anaesthesia machine as a possible cost effective alternative

Master Thesis

2015

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University of Cape Town

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Background: A new appreciation of relevant risks, as well as the increased availability of technologies that facilitate the use of regional techniques, have increased the number of patients that are allowed to breathe spontaneously during their procedures. The ever-growing caseload of surgical patients in resource poor environments demands an anaesthetic service and equipment capable of meeting with these demands. Methods: Patients were recruited to receive their general anaesthesia by means of either the Universal Anaesthesia Machine (UAM) or the standard plenum system available. Anaesthesia was administered according to a protocol and the consumption of electricity, carrier gases, volatile hypnotic agent and carbon dioxide absorbent was measured. The cost per minute was then calculated for each device respectively. Results: Our study recruited 50 patients (25 into each group) across several surgical specialties. We found that when calculated as a total South African Rand (ZAR) per minute cost (for our centre) the UAM was statistically significantly more expensive (R 0.974/min vs. R 0.459/min, p < 0,00001). We were able to derive equations to predict the cost consumption of the respective devices, allowing the use of this data in a wide array of clinical settings. Conclusion: Whilst our finding is by no means surprising, it allowed us to produce formulae by which individual centres can calculate the implications of each option using the specific costs of the various consumables available to them.
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