Estimated cost of anaesthesia. Do we know the economic impact involved in our daily clinical practice? 

Background and Goal of Study: It is essential an efficiently manage of limited health resources. In anaesthesiology we can better manage resources making rational use and assessing risk-benefit, but for this reason we need to know the cost of drugs and devices used. Our objective was to estimate the degree of knowledge of anaesthetics costs by nursing, anaesthesia and surgery staff and its possible influence on the choice of anaesthetic technique

Materials and Methods: Surveys were distributed to surgical nursing, anaesthesiologists and surgeons. Each survey consisted of four cases with four frequent interventions (total hip replacement, inguinal hernia repair, duodenopancreatectomy and breast reduction). Participants should choose the type of anaesthesia, reasons for choice and estimated cost (euros). The most common type of anaesthesia for each case and their estimated cost (drugs and consumables used) by specialty and years of experience (≥5 or <5) were analyzed. Data were compared with prices of our hospital purchasing department. It was calculated Ch2 statistical analysis for qualitative variables, t of Students for quantitative variables and ANOVA, CI 95% and p <0.05.

Results and Discussion: 100 surveys were distributed to surgical nursing (18%), anesthesiologists (40%) and surgeons (42%). Subarachnoid anaesthesia and sedation was chosen for total hip replacement by 95% of respondents. The overall average estimated cost of €153.12 (IC 95% (143.20- 162.92)), 928% higher than the actual cost.  57% chose hernia repair with spinal anaesthesia and sedation, with an overall average estimated price of €127.72 (IC 95% (117.92–137.52)). In duodenopancreatectomy, 44% opted for balanced general anaesthesia with sevoflurane combined with epidural catheter, with an estimated average cost of €488.64 (IC 95% (439.64–537.64)), 117% more than the actual cost; except anaesthesia who infraestimated 68.67%. In breast reduction 37% chose TIVA, with an estimated average cost of €298.50 (IC 95% (269.11-327.91)), 685.75% overestimated. There were no differences between specialties or experience. Though anaesthesia was closer to the price respect to other professionals (p<0.001) the difference was very important in practice and had no relevance.

Conclusions: Nursing and medical staff did not know the cost of anaesthesia, tending to overestimate the price of drugs and devices.