A cost analysis of reusable and disposable flexible optical scopes for intubation

Acta Anaesthesiol Scand. 2012 May;56(5):577-84. doi: 10.1111/j.1399-6576.2012.02653.x. Epub 2012 Feb 16.


Background: Intubation using a flexible optical scope (FOS) is a cornerstone technique for managing the predicted and unpredicted difficult airway. The term FOS covers both fibre-optic scopes and videoscopes. The total costs of using flexible scopes for intubation are unknown. The recent introduction of a disposable flexible scope for intubation merits closer scrutiny of the total costs associated with both modalities.

Methods: The costs incurred during intubations using FOSs at a large anaesthesia department were identified, and a series of intubations using a disposable scope were analyzed for comparison. Recognized health-economic methodology was applied.

Results: During a 1-year period, 360 FOS intubations were performed. In this clinical setting, the average cost of an intubation using a reusable FOS was €177.7. When using the disposable Ambu(®) aScope (Ambu A/S, Ballerup, Denmark), the cost was €204.4. The break-even point, i.e. the number of intubations per month where the cost of using disposable and non-disposable equipment is identical, was 22.5/month. A subgroup analysis looking solely at intubations performed with flexible videoscopes revealed that the cost per intubation was equal for disposable and reusable videoscopes.

Conclusion: At our institution, the total cost of an intubation is greater when using disposable compared with reusable equipment (€204.4 vs. €177.7). If video equipment with an external monitor is considered mandatory, the expenses are of equal magnitude. The cost analysis is particularly sensitive to the actual number of flexible optic intubations performed; with fewer intubations, the total cost will begin to favour disposable equipment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthesia, Inhalation
  • Costs and Cost Analysis
  • Databases, Factual
  • Denmark
  • Disposable Equipment / economics*
  • Equipment Reuse / economics*
  • Fiber Optic Technology
  • Humans
  • Intubation, Intratracheal / economics*
  • Intubation, Intratracheal / instrumentation*
  • Laryngoscopes / economics*
  • Personnel, Hospital / economics
  • Retrospective Studies
  • Sterilization / economics