Document Type
Poster
Publication Date
5-2026
Abstract
Background: Reversal of neuromuscular blockade by popular non-depolarizing muscle relaxants is a critical component of routine, safe anesthetic practice. Sugammadex, a modified gamma-cyclodextrin, has largely replaced acetylcholinesterase inhibitors and is recommended as the primary reversal agent by the American Society of Anesthesiologists. However, sugammadex is commonly supplied in 200 mg single-use vials, which may result in drug waste when smaller doses are required. This quality improvement project evaluated whether the introduction of 50 mg prefilled syringes at our facility could reduce drug waste and overall cost.
Methods: Following implementation of 50 mg syringes, a retrospective chart review was conducted over a 4-month period. Cases in which 50 mg syringes were dispensed were included. Actual drug utilization and cost (combination of 50 mg syringes and 200 mg vials) were compared to a hypothetical 200 mg vial-only strategy. Total and per-case costs were calculated, and a paired t-test was used to assess differences in cost. Drug waste was calculated descriptively.
Results: Sixty-nine patients (42 female, 27 male; age range 17–80 years) with complete data were included. Total cost using the mixed-syringe approach was $6,001.82 compared to $11,251.71 with a 200 mg vial-only strategy. Mean cost per case was significantly lower with 50 mg syringe availability ($86.98 vs $163.07, p < 0.001), representing an average savings of $76.09 per case and total savings of $5,249.89. In the 200 mg vial-only scenario, total drug waste was 5,900 mg (85.5 mg per case on average), whereas waste was eliminated with use of 50 mg syringes.
Conclusions: Implementation of 50 mg sugammadex syringes was associated with substantial cost savings and reduction of medication waste. This represents a simple, scalable intervention to improve perioperative resource utilization. However, adoption of 50 mg sugammadex syringes by clinicians remains limited at our facility and given the economic benefit, should be an area of emphasis for the department.
Persistent Identifier
http://hdl.handle.net/10950/5157
Journal/Conference Details
Presented at the UT Tyler Quality Improvement and Research Day