Audit on Wastage of Commonly Used Anaesthetic and Analgesic Agentsin Developing Country: The Case of Ethiopian University Teaching Hospital

Background: Anaesthetic drug wastage is a common challenge encountered in current anaesthetic care. Drug wastage is a potential area that significantly contribute for unnecessary health care budget allocation and financial lose. The aim of this study was to assess the amount of anaesthetic drug wastage and to analyze the cost of wasted drug in four operation room. Methods: A prospective observational study was conducted from January 10 to January 26, 2017 in the threemajor surgical and one obstetric operation room of university of Gondar teaching hospital. During consecutive period, data on amount of drug used or discarded were collected on patients undergoing surgical procedures under general or spinal anaesthesia. The total cost of used and wasted drug was estimated. Result: Of 86 patients included in the study, 54.6% were operated under general anaesthesia and 31.4% were under spinal anaesthesia. From 18 commonly used anaesthetic drugs, 16 of drugs were included into the final analysis. Of 16 different anaesthetic drugs, the maximum amount of wastage after loaded in syringes but not used, partially unused in ampoules or vials per case basis were seen in propofol, tramadol, and diclofenac (23.72 mg, 18 mg, and 10.6 mg, respectively). A total of 1967.8 Ethiopian birr (89.44 USD) were the cost of wasted drugs, of these the cost of wasted bupivacaine was maximum (33.8%). Conclusion: There was a significant amount of anaesthetic drugs and financial wastage during perioperative anaesthetic management for different surgical procedure. The use of drugs like neostigmine, metoclopramide, cimetidine and acetaminophen was best practice of usage during the study period no wastage was seen in those drugs. The use of fentanyl was also good which is 3.7% compared to other drugs.