Anesthetic drug wastage in the operation room: A cause for concern

Abstract

Context:The cost of anesthetic technique has three main components, i.e., disposable supplies, equipments, and anesthetic drugs. Drug budgets are an easily identifiable area for short-term savings.Aim:To assess and estimate the amount of anesthetic drug wastage in the general surgical operation room. Also, to analyze the financial implications to the hospital due to drug wastage and suggest appropriate steps to prevent or minimize this wastage.Settings and Design:A prospective observational study conducted in the general surgical operation room of a tertiary care hospital.Materials and Methods:Drug wastage was considered as the amount of drug left unutilized in the syringes/vials after completion of a case and any ampoule or vial broken while loading. An estimation of the cost of wasted drug was made.Results:Maximal wastage was associated with adrenaline and lignocaine (100% and 93.63%, respectively). The drugs which accounted for maximum wastage due to not being used after loading into a syringe were adrenaline (95.24%), succinylcholine (92.63%), lignocaine (92.51%), mephentermine (83.80%), and atropine (81.82%). The cost of wasted drugs for the study duration was 46.57% (Rs. 16,044.01) of the total cost of drugs issued/loaded (Rs. 34,449.44). Of this, the cost of wastage of propofol was maximum being 56.27% (Rs. 9028.16) of the total wastage cost, followed by rocuronium 17.80% (Rs. 2856), vecuronium 5.23% (Rs. 840), and neostigmine 4.12% (Rs. 661.50).Conclusions:Drug wastage and the ensuing financial loss can be significant during the anesthetic management of surgical cases. Propofol, rocuronium, vecuronium, and neostigmine are the drugs which contribute maximally to the total wastage cost. Judicious use of these and other drugs and appropriate prudent measures as suggested can effectively decrease this cost.

Audit on Wastage of Commonly Used Anaesthetic and Analgesic Agentsin Developing Country: The Case of Ethiopian University Teaching Hospital

“…The later might be the contributing factor for the significant percentage of atropine wastage in this audit. The result of this study was in line with other studies [4,5,8]. Wastage of emergency drugs (atropine and adrenaline) is an alarming problem in our hospital and the possible strategies to reduce wastage might be development of protocol, first load 1 mg of adrenaline or atropine in 10 ml syringe with saline and then load and dilute in separate syringes for each operation room at the start of standard working day, prefilled syringe with saline prepared and then the emergency drug will be drawn when critical incident happened, preparation of an emergency kit and putting in an area near for all theater, and ensuring easy availability and familiar for all staffs.…”

“…In average, around 100% of loaded adrenaline was wasted in our operation theater. This finding was comparable with other study [4]. This could be explained by the routine practice of drawing 1 mg/ml of adrenaline for treatment of unanticipating intraoperative incidents, by the anaesthetist or students.…”

“…Prevalence of drug wastage might be high during use of IV anaesthetic, unexperienced anaesthetist, working alone, and trainees. It is also prevalent when working in new setup, handling for emergency and pediatric patients [2,3,4]. Current evidence shows that discarding of unused intravenous anaesthetic agents are common due to different reasons, when compared to inhalational anaesthetic agents, are packed in subtle volume [5,6].…”

The Wastage and Economic Effects of Anaesthetic Drugs and Consumables in the Operating Room

“…Using current approaches is essential to keep pace with information technology and pharmaceutical advances, and improve the quality of healthcare. However, these innovations contribute to the increase of continuous medical expenses in terms of hospital expenses ( 1 ). Because of increasing health expenditure, cost-reduction strategies have become very important in developing countries.…”

Inhaled anesthetics contributing to drug wastage

“…[1] We congratulate the authors for raising an important concern of drug wastage related to our daily clinical practice.…”