Today's newest anesthesia machines are largely driven by electronics: Vaporizers, variable ventilation modes, flow meters and automated leak checks, and calibration tests are all electronic, making precise and cost-effective delivery simple. Keep in mind, though, that a more complex system increases the probability that maintenance will be required. And when it comes to anesthesia machines, waiting more than 1 day for service is an unthinkable proposition, especially if your facility has only 1 machine. No matter which model of anesthesia machine you choose, determine the proximity, availability and reliability of the service representative you'll be depending on to get your providers back to work. Other buying considerations:

• How much will it cost? From an administrative standpoint, an anesthesia machine's cost is the primary concern. The answer to this question is actually a function of a few other questions, including: How much machine do you need? New models run from about $25,000 to more than $100,000, depending on their options. Because you want to provide quality patient care without over- or under-buying, it's vitally important that you include your anesthesia providers' input in your selection, which must include a hands-on trial. Additionally, do you have contracts or affiliations with group purchasing organizations or distributors? These may limit your selection or secure you a reduced cost.

• New or refurbished? Every new anesthesia machine will include the basic monitoring, agent analysis and ventilation capabilities that your anesthesia providers require. Alternatively, you can buy remanufactured machines at significant discounts through manufacturers or pre-owned equipment dealers. You'll want to make sure, however, that a refurbished model includes the basics that practice standards demand and, depending on the equipment's age, whether parts and support are still available from the original manufacturer or must be ordered from an after-market supplier, which may raise patient safety concerns. Either way, new or refurbished, it may be advisable to seek compatibility between the anesthesia machine and electronic records systems, PACU monitors, blood pressure cuffs and other external equipment.

Dräger Medical
Fabius Tiro
www.draeger.us
(800) 4-DRAGER
Price-range: $24,000 to $30,000, depending on configuration
FYI: Developed for use in facilities in which space is at a premium, Dräger's Fabius Tiro combines advanced ventilation and gas delivery technologies with an ergonomic and compact design. The ability to add Dräger's high-performance Infinity patient monitoring system, the open modular architecture and the software/hardware upgradeability ensure that the workstation can meet current and future demands.

DRE Medical
Integra AV-S
www.dremed.com
(800) 499-7093
List price: starts at $19,000
FYI: The Integra AV-S's advanced, easy-to-use features ensure maximum patient safety. It's equipped with 2 vaporizers and is specifically designed for low-flow anesthesia. It features a large, integrated touchscreen ventilator with volume and pressure ventilation, plus SMMV, SIMV, PSV and PEEP. Its wider stance offers anesthesia providers a larger work area. An optional service-training program is also available from DRE Medical.

GE Healthcare
Aespire View
www.gehealthcare.com
(800) 345-2700
List price: not disclosed
FYI: GE Healthcare's Aespire View is a compact anesthesia solution that features a large, 12-inch color ventilator display and a full suite of ventilation modes. The company's Advanced Breathing System is well suited for low-flow anesthesia, and the optional Total Flow Sensing module electronically measures, displays and exports both individual gas flow and total fresh gas flow data to help manage costs.

Maquet
FLOW-i Anesthesia Delivery System
www.maquetusa.com
(888) 627-8383
Price-range: $70,000 to $120,000, depending on configuration
FYI: An innovative re-breathing technology in Maquet's FLOW-i replaces both traditional bag-in-bottle and piston for quick and precise wash-in and wash-out of anesthetic agent, while providing high performance, ICU-quality ventilation for all patient categories, including the most challenging. Open architecture supports the patient monitor of choice and the fully electronic platform is EMR-ready. Ergonomically designed, the system can be configured to workflow requirements.

Penlon
Prima SP2 Anesthesia System
www.penlon.com
(800) 328-6216
Price-range: $25,000 to $30,000
FYI: Penlon's Prima SP2, with its integrated AV-S Ventilator (which includes up to 6 ventilation modes) and A200SP Absorber (featuring a ventilator interface) gives anesthesia providers an easy-to-use, advanced anesthesia system. Ultra-low-flow anesthesia provides economical and environmental use. The system's modular open architecture offers users a choice of monitor and accessory layout for custom-built workstations.

Spacelabs Healthcare
BleaseFocus
www.spacelabshealthcare.com
(800) 522-7025
List price: not disclosed
FYI: An open-platform design and easy monitor mounting gives BleaseFocus users the flexibility to configure the system to their own anesthesia needs and budget. It features a compact breathing system, plus optional cascade flow tubes and advanced ventilation modes for cost effectiveness and environmental friendliness. Its ergonomic structure includes large work surfaces and 2 storage drawers.