Anesthesiologists (ASA) member survey (see "Top 10 Drugs in
Shortest Supply").
The shortage has forced all of us to improvise, conserving and
rationing what drugs we already have and using less familiar IV opi-
oids, such as sufentanil and remifentanil. When we are continually
changing protocols and forced to deviate from our usual practices, the
chance of dosing errors is an obvious danger.
"I'm having to use much older drugs with more significant side
effects that seriously impact efficiency, quality and patient satisfac-
tion," says one ASA survey respondent. "Patient safety is also at risk
since many healthcare professionals have little to no experience deal-
ing with these older drugs."
We are all increasing our use of regional anesthesia and other multi-
modal techniques. The run on local anesthetics has reportedly dimin-
ished supplies of bupivacaine, lidocaine and ropivacaine, plunging
them into shortage as well.
"The local anesthetic shortage caused us to suspend our acute
pain service for nearly 4 weeks, resulting in patients experiencing
more pain, higher narcotic usage and unnecessary admission," says
a survey respondent.
Another alternative is to use oral opioids, but as a survey respon-
dent noted, oral treatments take far longer to work than IV treatment.
"So patients who have had major surgeries are suffering in pain due
to a lack of quick-acting medications," says the anesthesiologist. "I
have had patients ask me about the drug shortages as they have been
publicized in the news and they fear surgery due to the impending
pain they'll have post-operatively."
What's causing the shortage?
A confluence of events has conspired to create the acute drug short-
J U N E 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 1 9
