Low-flow anaesthesia. Does it have potential pharmacoeconomic consequences?

Healthcare reform has placed increasing pressure on anaesthetists to consider the costs of current anaesthesia strategies. Although the cost of anaesthesia constitutes only a small proportion of total healthcare costs, anaesthetic drug expenditures have been a focus of cost-containment efforts. Low-flow anaesthesia is a simple method of reducing the fresh gas flow rate for anaesthetic gases during inhalational anaesthesia. A knowledge of the pharmacokinetic behaviour of inhaled anaesthetics and the use of modern equipment and monitoring technology meet the requirements for safe application of this anaesthetic technique. Millions of patients receive general anaesthesia each year, and thus the use of this technique could generate substantial savings in anaesthetic drug expenditure without reducing the patient's comfort or increasing adverse events. The new inhaled anaesthetics desflurane and sevoflurane, which have low tissue solubility, provide promising options when used in low-flow anaesthesia. Apart from the economic advantages, low-flow anaesthesia helps to reduce environmental pollution and is associated with several physiological benefits for the patient. Low-flow anaesthesia is a simple but highly effective method of cost minimisation that can be applied to a large number of patients without any compromise in patient care or safety.