Sugammadex compared with Neostigmine/Glycopyrrolate: An Analysis of Total PACU Time, Responsiveness, and Potential for Economic Impact
Studies have previously shown sugammadex works faster and more effectively than neostigmine/glycopyrrolate at reversal of neuromuscular blockade by rocuronium and vecuronium. The purpose of this quality improvement study was to evaluate for differences in patient time spent in the operating room (O...
Main Authors: | , , |
---|---|
Format: | Article |
Language: | English |
Published: |
University of Minnesota Libraries Publishing
2019-07-01
|
Series: | INNOVATIONS in Pharmacy |
Subjects: | |
Online Access: | https://pubs.lib.umn.edu/index.php/innovations/article/view/1798 |
id |
doaj-1d7934d7bfa74bad8b2c8011be58db80 |
---|---|
record_format |
Article |
spelling |
doaj-1d7934d7bfa74bad8b2c8011be58db802020-11-25T03:26:40ZengUniversity of Minnesota Libraries PublishingINNOVATIONS in Pharmacy2155-04172019-07-0110310.24926/iip.v10i3.1798Sugammadex compared with Neostigmine/Glycopyrrolate: An Analysis of Total PACU Time, Responsiveness, and Potential for Economic ImpactYoon Jung Lee0Kayla Leigh Money1Amber Elliott2BSA Health System and Texas Tech University Health Sciences CenterBaptist Saint Anthony HospitalTexas Tech University Health Sciences Center Studies have previously shown sugammadex works faster and more effectively than neostigmine/glycopyrrolate at reversal of neuromuscular blockade by rocuronium and vecuronium. The purpose of this quality improvement study was to evaluate for differences in patient time spent in the operating room (OR), post-anesthesia care unit (PACU), and patient responsiveness between the sugammadex and neostigmine/glycopyrrolate groups at a small surgical center. Additionally, a cost analysis was conducted to assess potential savings associated with sugammadex use, taking into account the differences in OR time, PACU time, and medication acquisition cost. We conducted a prospective analysis of OR time, PACU time, and responsiveness for a total of 152 patients, 76 patients receiving neostigmine/glycopyrrolate and 76 patients receiving sugammadex, undergoing planned surgery over an 8-week period. We identified an average decrease in total OR time of 6 minutes in the sugammadex group (neostigmine/glycopyrrolate [Mean: 86 min, Median: 77 min, Range 32-211 min] vs sugammadex [Mean: 80 min, Median: 77 min, Range 40-150 min]). Furthermore, there was an average decrease in total PACU time of 6 minutes in the sugammadex group (neostigmine/glycopyrrolate [Mean: 60 min, Median: 56 min, Range 32-154 min] vs sugammadex [Mean: 54 min, Median: 51 min, Range: 28-94 min]). Additionally, the percent of patients fully awake at the end of PACU stay was higher in the sugammadex group than the neostigmine/glycopyrrolate group (86% vs 79% respectively). Cost was evaluated for generating hypotheses. The additional cost of using sugammadex was estimated at $77 per person when compared to neostigmine/glycopyrrolate. However, if the use of sugammadex decreased the time in OR and PACU by an average of 12 minutes per patient, it is possible that it could provide a potential savings of $579 per patient after estimating a soft savings of reduced OR, PACU, and staff time. Overall cost saving per patient with sugammadex, which was calculated after subtracting additional medication acquisition cost, is $502. It is possible that if this value is extrapolated to 988 patients, this might suggest a potential cost savings of $495,976 per year. We hope this study provokes future research to determine if Sugammadex is a potentially viable economical option for the routine reversal of neuromuscular blockade. Article Type: Original Research https://pubs.lib.umn.edu/index.php/innovations/article/view/1798sugammadex, neostigmine, glycopyrrolate, post-anesthesia care unit, operating room, economic evaluation, cost analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yoon Jung Lee Kayla Leigh Money Amber Elliott |
spellingShingle |
Yoon Jung Lee Kayla Leigh Money Amber Elliott Sugammadex compared with Neostigmine/Glycopyrrolate: An Analysis of Total PACU Time, Responsiveness, and Potential for Economic Impact INNOVATIONS in Pharmacy sugammadex, neostigmine, glycopyrrolate, post-anesthesia care unit, operating room, economic evaluation, cost analysis |
author_facet |
Yoon Jung Lee Kayla Leigh Money Amber Elliott |
author_sort |
Yoon Jung Lee |
title |
Sugammadex compared with Neostigmine/Glycopyrrolate: An Analysis of Total PACU Time, Responsiveness, and Potential for Economic Impact |
title_short |
Sugammadex compared with Neostigmine/Glycopyrrolate: An Analysis of Total PACU Time, Responsiveness, and Potential for Economic Impact |
title_full |
Sugammadex compared with Neostigmine/Glycopyrrolate: An Analysis of Total PACU Time, Responsiveness, and Potential for Economic Impact |
title_fullStr |
Sugammadex compared with Neostigmine/Glycopyrrolate: An Analysis of Total PACU Time, Responsiveness, and Potential for Economic Impact |
title_full_unstemmed |
Sugammadex compared with Neostigmine/Glycopyrrolate: An Analysis of Total PACU Time, Responsiveness, and Potential for Economic Impact |
title_sort |
sugammadex compared with neostigmine/glycopyrrolate: an analysis of total pacu time, responsiveness, and potential for economic impact |
publisher |
University of Minnesota Libraries Publishing |
series |
INNOVATIONS in Pharmacy |
issn |
2155-0417 |
publishDate |
2019-07-01 |
description |
Studies have previously shown sugammadex works faster and more effectively than neostigmine/glycopyrrolate at reversal of neuromuscular blockade by rocuronium and vecuronium. The purpose of this quality improvement study was to evaluate for differences in patient time spent in the operating room (OR), post-anesthesia care unit (PACU), and patient responsiveness between the sugammadex and neostigmine/glycopyrrolate groups at a small surgical center. Additionally, a cost analysis was conducted to assess potential savings associated with sugammadex use, taking into account the differences in OR time, PACU time, and medication acquisition cost. We conducted a prospective analysis of OR time, PACU time, and responsiveness for a total of 152 patients, 76 patients receiving neostigmine/glycopyrrolate and 76 patients receiving sugammadex, undergoing planned surgery over an 8-week period. We identified an average decrease in total OR time of 6 minutes in the sugammadex group (neostigmine/glycopyrrolate [Mean: 86 min, Median: 77 min, Range 32-211 min] vs sugammadex [Mean: 80 min, Median: 77 min, Range 40-150 min]). Furthermore, there was an average decrease in total PACU time of 6 minutes in the sugammadex group (neostigmine/glycopyrrolate [Mean: 60 min, Median: 56 min, Range 32-154 min] vs sugammadex [Mean: 54 min, Median: 51 min, Range: 28-94 min]). Additionally, the percent of patients fully awake at the end of PACU stay was higher in the sugammadex group than the neostigmine/glycopyrrolate group (86% vs 79% respectively). Cost was evaluated for generating hypotheses. The additional cost of using sugammadex was estimated at $77 per person when compared to neostigmine/glycopyrrolate. However, if the use of sugammadex decreased the time in OR and PACU by an average of 12 minutes per patient, it is possible that it could provide a potential savings of $579 per patient after estimating a soft savings of reduced OR, PACU, and staff time. Overall cost saving per patient with sugammadex, which was calculated after subtracting additional medication acquisition cost, is $502. It is possible that if this value is extrapolated to 988 patients, this might suggest a potential cost savings of $495,976 per year. We hope this study provokes future research to determine if Sugammadex is a potentially viable economical option for the routine reversal of neuromuscular blockade.
Article Type: Original Research
|
topic |
sugammadex, neostigmine, glycopyrrolate, post-anesthesia care unit, operating room, economic evaluation, cost analysis |
url |
https://pubs.lib.umn.edu/index.php/innovations/article/view/1798 |
work_keys_str_mv |
AT yoonjunglee sugammadexcomparedwithneostigmineglycopyrrolateananalysisoftotalpacutimeresponsivenessandpotentialforeconomicimpact AT kaylaleighmoney sugammadexcomparedwithneostigmineglycopyrrolateananalysisoftotalpacutimeresponsivenessandpotentialforeconomicimpact AT amberelliott sugammadexcomparedwithneostigmineglycopyrrolateananalysisoftotalpacutimeresponsivenessandpotentialforeconomicimpact |
_version_ |
1724591394947858432 |