Comparison of Medication Usage and Costs in IVF Procedures: RN vs. CRNA-Administered Anesthesia

Objective To evaluate differences in medication dosages and associated costs when registered nurses (RNs) versus certified registered nurse anesthetists (CRNAs) administer anesthesia for IVF procedures. Design Retrospective chart review. Materials and Methods We reviewed anesthesia records from a private outpatient fertility center, comparing medication use and costs between procedures managed by RNs and those managed by CRNAs. Results A total of 185 patients (average age: 36 years; average BMI: 28) underwent egg retrievals (n = 109) or hysteroscopies (n = 76) with anesthesia administered by RNs. These cases required an average of 270 mcg fentanyl and 8.6 mg midazolam, with a mean medication cost of $16.18 per procedure. In contrast, 82 patients (average age: 34 years; average BMI: 28) had anesthesia provided by CRNAs for either an egg retrieval (n = 52) or hysteroscopy (n = 30). These procedures utilized 99 mcg fentanyl and 2 mg midazolam on average, along with 650mg propofol, resulting in a mean medication cost of $35.27 per procedure—$19.09 higher than RN-managed cases. Among 29 patients who underwent multiple procedures with both anesthesia models, RN-administered anesthesia used 288 mcg fentanyl and 9 mg midazolam, while CRNAs used 84 mcg fentanyl and 2 mg midazolam per procedure. Conclusions CRNAs used significantly lower doses of fentanyl and midazolam by incorporating propofol, leading to a higher average medication cost of $19.09 per procedure. The choice of anesthesia provider impacts both drug usage and cost, highlighting a trade-off between medication savings and anesthesia technique.