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theses

Purpose of Project: There are considerable cost concerns over sugammadex use despite its superiority over traditional neuromuscular blockade reversal methods, although the economic advantages potentially leading to cost-effectiveness of sugammadex use warrants further pharmacoeconomic investigation. In adult surgical patients who receive neuromuscular blockers during general anesthesia, how cost effective is sugammadex use in comparison to neostigmine and glycopyrrolate in reducing cost by means of reduced postoperative discharge time from the OR to PACU and PACU to discharge, during the perioperative period following a retrospective chart review over three months?

Methodology: SPSS software was utilized for all data analysis and descriptive statistics with data gathered from the chart review including medication groups, American Society of Anesthesiology (ASA) physical status classification, and OR and PACU discharge time in minutes. Descriptive statistics and multiple parametric tests were completed to determine statistical significance and association between the variables. Furthermore, data results were presented to a group of anesthesia providers along with a pre and post surveys assessing providers knowledge of pharmacoeconomic principles.

Results: Overall the first data set suggests statistical significance between the variables of medication administered and anesthesia duration time and the second data set did not. However, the clinical significance and economic gain of overall cost-effectiveness is highly reliant upon utilization of time saved with sugammadex use versus that of neostigmine and warrants further investigation. Furthermore, the statistical analysis completed on the surveys did not demonstrate a significant difference between mean scores

Implications for Practice: Although a statistically significance p-value (0.49) was only obtained for the anesthesia duration time in the OR in both the neostigmine and sugammadex group, independent of ASA, the data, specifically the reduction in OR and PACU time in the sugammadex group, suggests that providers/stakeholders may be overlooking economic advantages that may not be readily apparent. To demonstrate the true pharmacoeconomic impact of sugammadex at the implementation facility, a randomized controlled trial should be conducted, so a pure sample can be evaluated. Moreover, performing an analysis over a greater length of time will increase the sample size which will more likely lead to a greater amount of statistically significant results.

ETD_10693

DNP

Includes bibliographical references

doi:10.7282/t3-pfze-5k90

ETD doctoral

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