1. In the current environment of cost containment, clinicians are constantly pressured to use less expensive anesthetic agents, including antiemetics, neuromuscular blocking drugs, and volatile anesthetics.
2. Factors involved in value-based decisions include drug efficacy (all volatile anesthetics are similar in efficacy) and side effects (hepatic toxicity and cardiac sensitization cause by halothane offset its low cost).
   1. The need for rescue medications to treat nausea and vomiting after volatile anesthesia should be weighed in any cost analysis.
   2. Reducing the fresh gas flow of sevoflurane and desflurane can decrease by half the cost per MAC hour of these more expensive anesthetics without compromising their speed and effectiveness.

Inhaled Anesthetics

1. Pharmacokinetic Principles
2. Clinical Overview of Current Inhaled Anesthetics
3. Neuropharmacology of Inhaled Anesthetics
4. The Circulatory System
5. The Pulmonary System
6. Hepatic Effects
7. Neuromuscular System and Malignant Hyperthermia
8. Genetic Effects, Obstetric Use, and Effects on Fetal Development
9. Anesthetic Degradation by Carbon Dioxide Absorbers
10. Anesthetic Metabolism
11. Clinical Utility of Volatile Anesthetics
12. Pharmacoeconomics and Value-Based Decisions