[Show abstract][Hide abstract] ABSTRACT: 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.
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.
A prospective observational study conducted in the general surgical operation room of a tertiary care hospital.
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.
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).
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.
No preview · Article · Mar 2012 · Journal of Anaesthesiology Clinical Pharmacology
[Show abstract][Hide abstract] ABSTRACT: Background: To compare the effects of propofol vs halothane on respiratory gas exchange during laparoscopic cholecystectomy in a prospective randomized manner. Patients & Methods: Forty ASA grade I and II patients aged between 20-50 years were divided randomly between halothane (HG) and propofol (PG) groups. Ventilatory settings remained unchanged during pneumoperitoneum (PP) until 10 min after deflation of the peritoneal cavity. Blood gas analyses were performed at: 5 min after induction of anaesthesia (pre-PP values), immediately before carbon dioxide insufflation (0 min PP), after both 30 and 60 min of PP and 10 min after deflation of the peritoneal cavity. Maximal inspiratory pressure, intraabdominal pressures were continuously monitored. The difference between arterial and end-tidal co2 partial pressures (P(a-et)co 2) was calculated to allow assessment of physiological dead space by the modified Bohr's Equation. Results: Both groups were similar in respect to clinical characteristics. Pulmonary gas exchange differed significantly after 30 and 60 min of PP between the HG and the PG. During CO2 insufflation the P(a-et)CO2 increased significantly in the HG ,while the values in the PG remained constant. Conclusion: During and after laparoscopic cholecystectomy using halothane as the anaesthetic agent, the PaCo2 is significantly higher, physiological dead space significantly enlarged and the PaO2 significantly lower than they are with propofol.
No preview · Article · Jul 2008 · Journal of Anaesthesiology Clinical Pharmacology