Surgical drug shortages put patients at risk

The U.S. is facing ongoing shortages of several critical anesthesia medications, which could have potentially serious effects on patient care and safety, according to a special report in Anesthesia & Analgesia (December 2011, Vol. 113:6, pp. 1429-1435).

Gildasio De Oliveira Jr., MD, and colleagues at Northwestern University reviewed key issues related to national shortages of important drugs used perioperatively and found that medication shortages have become increasingly frequent over the past decade. In 2010, the American Society of Health System Pharmacists listed 140 medications in short supply. Shortages are especially acute for sterile injectable medications because of the many complex steps involved in their manufacture, according to the study authors.

Of special concern to anesthesiologists is the shortage of propofol (Diprivan), they noted. Propofol is one of the most preferred and widely used anesthetics in medicine, but in recent years the drug's manufacturers have been plagued with a series of issues -- including product recalls and a multimillion-dollar lawsuit -- that have made it increasingly difficult to obtain.

Drug shortages can have a devastating impact on patient care -- particularly if alternative drugs are not available, according to the researchers. Patients may face treatment delays, have procedures canceled, or receive alternative drugs that are less effective or have more side effects.

Dr. De Oliveira and his colleagues urge anesthesiologists to take the lead in dealing with the problem of shortages, noting that "proactive measures must be taken to identify, resolve, and possibly prevent a medication shortage before patient care and safety are jeopardized."