Cost-utility analysis of the insufflation of warmed humidified carbon dioxide during open and laparoscopic colorectal surgery

<p><b>Background:</b> An evaluation was conducted to estimate the cost-effectiveness of insufflation of warmed humidified CO<sub>2</sub> during open and laparoscopic colorectal surgery compared with usual care from a UK NHS perspective.</p> <p><b>Methods:</b> Decision analytic models were developed for open and laparoscopic surgery. Incremental costs per quality-adjusted life year (QALY) were estimated. The open surgery model used data on the incidence of intra-operative hypothermia and applied risks of complications for hypothermia and normothermia. The laparoscopic surgery model utilised data describing complications directly. Sensitivity analyses were conducted.</p> <p><b>Results:</b> Compared with usual care, insufflation of warmed humidified CO<sub>2</sub> dominated. For open surgery, savings of £20 and incremental QALYs of 0.013 were estimated per patient. For laparoscopic surgery, savings of £345 and incremental QALYs of 0.001 per patient were estimated. Results were robust to most sensitivity analyses.</p> <p><b>Conclusions:</b> Considering the current evidence base, the intervention is likely to be cost-effective compared with usual care in patients undergoing colorectal surgery.</p>