Juan Carlos Ramírez-Mora

Undocumented drug utilization and drug waste increase costs of pediatric anesthesia care

The present study was performed in order to identify the cost of drugs used without documenting them in the patients’ file and the wastage of drugs in a pediatric anesthesiology ward. In a prospective, blinded, observational design, drug utilization of 610 consecutive patients, undergoing an elective or emergency surgical procedure was evaluated. The number of undocumented drugs per 100 requested units and the number of wasted drugs per 100 requested units were computed and multiplied by its corresponding unitary cost. The median undocumented cost was US

Preferences of Mexican anesthesiologists for vecuronium, rocuronium, or other neuromuscular blocking agents: a survey

92.4 (95% CI

Attitudes of Mexican anesthesiologists to indicate preoperative fasting periods: A cross-sectional survey

17.2–

Prolonged preoperative fasting periods prescribed by residents in pediatric anesthesia

216.6) per 100 requested units. Succinylcholine (40 mg/2 mL) was the main undocumented drug; its use was not documented in approximately 50% cases in which this neuromuscular blocking agent was requested. However, rocuronium and nalbuphine had the highest unjustified cost,

Halothane, isoflurane and sevoflurane in pediatric anesthesia: can we decrease costs without increasing adverse events?

770.6 and

Minimización de dosis de bupivacaína y ropivacaína para analgesia epidural en infusión

847.0 per 100 requested units, respectively. Ketorolac, diclofenac, metamizol, furosemide, methylprednisolone, sodium bicarbonate, and cisatracurium were requested and documented. The median cost of wasted drug was

Modificación de los parámetros hemodinámicos y BIS durante la inducción con propofol versus propofol-ketamina en pacientes pediátricos

141.8 (95% CI

Cuidados paliativos en el Hospital Infantil de México «Federico Gómez»: una realidad

55.8–

Experiencia clínica con los relajantes neuromusculares en el Hospital Infantil de México «Federico Gómez»

448.2) per 100 requested drugs. More than 80% of adrenaline, naloxone, flunitrazepam, ephedrine, and cisatracurium were wasted. However, the highest cost of wasted drugs was for ondansetron, cisatracurium, methylprednisolone, and rocuronium. The uncontrolled availability and use of drugs may represent an important amount of resources wasted without any awareness of the staff in a department of pediatric anesthesia.

Remifentanyl para procedimientos endoscópicos en niños

BackgroundSeveral neuromuscular blocking (NMB) agents are available for clinical use in anesthesia. The present study was performed in order to identify preferences and behaviors of anesthesiologists for using vecuronium, rocuronium or other NMB agents in their clinical practice.Material and methodsThe cross-sectional survey was applied at the Updated Course of the Colegio Mexicano de Anestesiología performed last year. Of 989, 282 (28.5%) surveys were returned.ResultsMost anesthesiologists were working at both public and private hospitals, performed anesthetic procedures for hospitalized and ambulatory patients, and anesthetized children as well as adults. Respondents did not consider mechanomyography as the gold standard method for neuromuscular monitoring. The T25 was not recognized as a pharmacodynamic parameter that represents the clinical duration of the neuromuscular block. Most answered that vecuronium induces less histamine release than rocuronium, had never used any neuromuscular monitor, did not know the cost of vecuronium and rocuronium, and preferred rocuronium in multiple-sampling vials and vecuronium in either a vial for single or multiple sampling. Rocuronium was preferred for emergency surgery in patients with full stomach only. Almost all of anesthesiologists that conserve the unused drug did it without refrigeration and more than 30% conserve the unused drug in one syringe for further use.ConclusionVecuronium was preferred for most clinical situations, and the decision for this choice was not based on costs. Storage of unused drugs without refrigeration in a single syringe for purpose of future use in several patients represented a dangerous common practice.