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

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.