title: Anesthetic drug wastage in the operation room: A cause for concern.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  A prospective observational study conducted in the general surgical operation room of a tertiary care hospital.
  
  
  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.
authors.affiliation: Department of Anesthesiology and Intensive Care, Gobind Ballabh Pant Hospital, New Delhi, India.
authors.forename: Kapil
authors.initials: K
authors.lastname: Chaudhary
authors.forename: Rakesh
authors.initials: R
authors.lastname: Garg
authors.forename: Anju R
authors.initials: AR
authors.lastname: Bhalotra
authors.forename: Raktima
authors.initials: R
authors.lastname: Anand
authors.forename: Kk
authors.initials: K
authors.lastname: Girdhar