# Costs and Arising Work Times of Volatile Short-Term Sedation in Intensive Care

## TL;DR

This study compares the costs and time required for volatile sedation versus intravenous sedation in intensive care, finding that volatile sedation is more expensive but has minimal additional setup time.

## Contribution

The study provides a novel economic evaluation of volatile sedation in intensive care, comparing costs and workload with intravenous methods.

## Key findings

- Volatile sedation requires additional setup time but minimal accumulation.
- The cost of volatile sedation is higher due to single-use reflector devices.
- Conventional propofol-based sedation remains cheaper in short-term use.

## Abstract

Background: Optimizing critical care sedation is an important and complex task. Although intravenous sedatives are widely used, they do have limitations compared to volatile sedatives, such as faster awakening and minimal accumulation. However, volatiles are still rarely used due to technical barriers and costs. We intended to conduct an economic evaluation on the workload and efficiency of short-term volatile sedation. Methods: Retrospective secondary data analysis of the cost of 60 min sedation after cardiac valve surgery performed at a tertiary center (n = 94), including assessment of material turnover, substance consumption and personnel expenses combined on a monetary basis. Results: The time required for bedside preparation was extended from almost 18 min (i.v. sedation) to an additional 9–10 min when applying volatile sedatives. We calculated a median sevoflurane consumption of 23 mL using MIRUSTM and 14 mL using Sedaconda, resulting in an average price of EUR 38.43 for propofol, EUR 13.24 for sevoflurane under Sedaconda, and EUR 15.03 using MIRUSTM for application in the monetary evaluation. The total prices were calculated based on an additionally optimized scenario of weekly use of a MIRUSTM reflection device system, at EUR 128.99 versus EUR 119.73 (Sedaconda) versus EUR 48.44 for conventional propofol-based sedation. Conclusions: The use of volatile sedation in intensive care has a higher price in short-term use due to the cost of the single-use reflector of the anesthetic conserving device, which is difficult to offset financially against the pharmacological benefits in terms of faster recovery. However, the additional setup times are relatively short. Clinical benefits such as faster recovery were not included in the cost analysis.