Pub Date : 2024-12-01Epub Date: 2024-11-22DOI: 10.11648/j.ijacm.20241202.18
Huang Huang, Emily Lai, Shreyas Bhavsar, Brian Miller, Jovelle Chung, Bradly Phillips, Lei Feng, Jose Miguel Soliz, Jessica Brown
Background: The rapidly acting opioid fentanyl commonly used in the perioperative setting, has traditionally been packaged in 100 or 250-μg vials. In September 2021, our institution implemented a change from fentanyl 100-μg vials to 50-μg preloaded syringes in our operating rooms. The objective of this study was aimed at assessing the association of the fentanyl product change on reducing medication waste and the amount of fentanyl administered during surgery.
Methods: This single-center, retrospective study entailed a review of anesthesia records from September 2020 to September 2022 of adult patients who underwent general anesthesia and received fentanyl for surgery at The University of Texas MD Anderson Cancer Center. The data set was divided into a control period (CP) using 100-μg vials and a post transition period (PT) using 50-μg preloaded syringes. The primary outcome measures were the average amounts of fentanyl used and wasted per case. Secondary outcome measures consisted of intraoperative analgesic use as well as postoperative pain scores.
Results: Among the 33,405 cases included in this study, the mean amount of fentanyl used per surgical case was higher in the CP group than in the PT group (133μg vs. 102μg; p<0.001). Additionally, fentanyl waste occurred in a higher percentage of cases in the CP group than in the PT group (13.9% vs. 2.9%; p<0.001). We did not observe a significant difference in post-anesthesia care unit pain scores between the CP and PT groups.
Conclusion: Transitioning to preloaded fentanyl syringes decreased medication waste and overuse of opioids intraoperatively. Simultaneously, the transition did not adversely affect patient analgesia in the post-anesthesia care unit.
背景：速效阿片类药物芬太尼通常用于围手术期，传统上包装在100或250 μg的小瓶中。2021年9月，我们机构在手术室实施了从100 μg芬太尼小瓶到50 μg预装注射器的更改。本研究的目的是评估芬太尼产品变化与减少手术期间药物浪费和芬太尼用量之间的关系。方法：这项单中心、回顾性研究回顾了2020年9月至2022年9月在德克萨斯大学MD安德森癌症中心接受全身麻醉并接受芬太尼手术的成年患者的麻醉记录。数据集分为使用100 μg小瓶的对照期（CP）和使用50 μg预装注射器的后过渡期（PT）。主要结局指标是每例芬太尼的平均使用量和浪费量。次要结果测量包括术中镇痛药的使用以及术后疼痛评分。结果：在本研究纳入的33,405例病例中，CP组芬太尼平均每例手术用量高于PT组(133μg vs 102μg；结论：过渡到预加载芬太尼注射器减少了术中药物浪费和阿片类药物的过度使用。同时，在麻醉后护理单元，这种转变对患者的镇痛没有不利影响。
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