Advances in pain management

Comparative study of modern anesthesia drugs

Abstract

In this large perioperative cohort study of a contemporary and diverse population of patients undergoing different types of surgery, different anesthesia drugs used as monotherapy were associated with differences in surgical outcomes. Patients anesthetized with propofol demonstrated longer PACU and hospital lengths of stay, especially after elective noncardiothoracic and bariatric surgery. We also demonstrated that use of ketamine as TIVA in bariatric may be associated with a higher risk of mortality overall when used as a single agent. These results could be an impetus to undertake multicenter studies of the association of anesthetic drugs such as propofol and ketamine and delay in recovery and increased mortality. Since the selection of anesthetic drugs might depend on a variety of clinical, patient, and provider factors between patients, we cannot conclude that the observed associations are due to cause-effect relationship. Our findings raise the possibility that the choice of relatively expensive anesthetic drugs may be associated with modest increases in hospital stays, and these costs have implications in resource utilization after implementing healthcare policies and bundled payments in the context of increasing economic pressure on surgical care providers.