• Hospital pharmacy · Oct 2015

    How Drug Shortages Affect Clinical Care: The Case of the Surgical Anesthetic Propofol.

    • Bryan Romito, Jonathan Stone, Ning Ning, Chen Yin, Ernesto M Llano, Jing Liu, Keerthan Somanath, Christopher T Lee, and Gerald Matchett.
    • Department of Anesthesiology & Pain Management, UT-Southwestern Medical Center , Dallas, Texas.
    • Hosp Pharm. 2015 Oct 1; 50 (9): 798-805.

    BackgroundPeriodic drug shortages have become a reality in clinical practice. In 2010, in the context of a nationwide drug shortage, our hospital experienced an abrupt 3-month shortage of the surgical anesthetic propofol. The purpose of this retrospective study was to survey the clinical impact of the abrupt propofol shortage at our hospital and to survey for any change in perioperative mortality.MethodsA retrospective before-and-after analysis, comparing May through July 2010 (group A, prior to the propofol shortage) to August through October 2010 (group B, during the propofol shortage).ResultsIn May through July 2010, before the propofol shortage, a majority of patients (80%) received propofol (group A, n = 2,830). In August through October 2010, during the propofol shortage, a majority of patients (81%) received etomidate (group B, n = 3,066). We observed that net usage of etomidate increased by more than 600% in our hospital. Baseline health characteristics and type of surgery were similar between groups A and B. Thirty-day and 2-year mortality were similar between groups A and B. The reported causes and frequency of mortality in groups A and B were also similar.ConclusionThe propofol shortage led to an increased usage of etomidate by more than 600%. In spite of that, we did not detect an increase in mortality associated with the increased use of etomidate during a 3-month propofol shortage.

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