The Impact of a Shortage of Pharmacy-Prepared XXXX Syringes on Intraoperative Medication Use.

@entity1 @entity2647 @entity6358
BACKGROUND: Anesthesia-related medication shortages have become increasingly common in the United States. We tested whether a local shortage of pharmacy-prepared @entity6358 syringes, replaced by provider-prepared @entity6358 , was associated with provider-level changes in @entity6358 and @entity2647 use and @entity1 -level changes in intraoperative hemodynamics. METHODS: Consecutive @entity1 undergoing general and orthopedic surgery at a tertiary care center were included 1 month before and 1 month after the start of the pharmacy-prepared @entity6358 syringe shortage. Lowest mean arterial blood pressure and slowest heart rate were obtained as measures of hemodynamics. Adjusted associations were tested using mixed-effects regression with repeated measures. RESULTS: Three hundred four @entity1 before the shortage and 298 @entity1 after the shortage began were included. The administration of at least 1 bolus of @entity6358 was significantly more common before versus during the shortage (148/304 [48.7]% vs 117/298 [39.3]%; P = 0.0199). After adjusting for age, sex, ASA physical status, surgery type, anesthesia provider, and operative duration, @entity1 were significantly less likely to receive @entity6358 during the shortage (relative risk [RR] = 0.78 [95% confidence interval {CI}, 0.61-0.96]; P = 0.0198) and more likely to receive a @entity2647 bolus (RR = 1.27 [95% CI, 1.02-1.51]; P = 0.0357). @entity1 hemodynamics assessed by slowest heart rate or lowest mean arterial blood pressure did not differ significantly during the shortage. CONCLUSIONS: There was an alteration in medication administration patterns during a shortage of pharmacy-prepared syringes. Changes in @entity6358 and @entity2647 use were noted; however, @entity1 hemodynamics remained comparable. Provider use patterns were sensitive even to a relative and not absolute medication shortage as observed in this study.
