Drug wastage contributes significantly to the cost of routine anesthesia care

Study Objective: To complement previous studies that employed indirect meth ods of measuring anesthesia drug waste. Design: Prospective, blinded observational study. Setting: Operating rooms of a single university hospital. Subjects: Anesthesia providers practicing in this setting who were complete ly unaware of the conduct of the study. Measurements: All opened and unused or unusable intravenous (IV) anesthesia drugs left over at the end of each workday were collected over a randomly selected typical 2-week period. Main Results: 166 weekday cases were performed. Thirty different drugs were represented in the 157 syringes and 139 ampoules collected. Opioid waste a s well as opened vials that became outdated were counted in the tally. Base d on actual hospital drug acquisition costs, $1,802 of drugs were wasted du ring this 2-week period ($300/OR), amounting to an average cost per case of $10.86. On a cost basis, six drugs accounted for three quarters of the tot al wastage: phenylephrine (20.8%), propofol (14.5%), vecuronium (12.2%), mi dazolam (11.4%), labetalol (9.1%), and ephedrine (8.6%). Because incomplete ly used syringes or vials that were discarded in the trash were not measure d in this analysis, the results may underestimate the total cost of drug wa stage at this institution by up to 40%. Conclusions: The results of this study are similar to those of previous stu dies that employed electronic record keeping techniques to calculate drug w aste. Intravenous drugs that are prepared but unused may be a significant c ost of intraoperative anesthesia care. Methods to reduce the amount of drug wasted are proposed. (C) 2001 by Elsevier. Science Inc.