[To reduce drug expenditure in the operating room (OR)--a paradigm]

The main advantages of pharmacy controlled IV preparations (CIVAS) are reduced expenditures, contaminations, and human errors. Today, IV preparations by physicians in the operating room (OR) are based on axioms such as: purchased drugs have standard dosages, IV are prepared immediately before operation, quantity of drug used is unpredictable due to patient's body weight and type of operation and opened injections can't be used for different patients and operations. Due to those limitations, the quantities of drugs used are significantly lower than supplied and wastage cost is high.

To optimize CIVAS and reduce drug expenditure, using techniques from management and engineering sciences.

A model of optimization, based on credibility and prediction tests was used to analyze CIVAS. The model uses parameters such as number and type of operations, drugs and quantities/operation. It identifies wastage for each drug used (quantities and cost) and predicts optimal doses and quantities to be prepared.

Although wastage (quantities) ranged from 30-70%, wastage cost was attributed mainly to two drugs: rocuronium (72%) and propofol (13 %). The model predicts that preparation of three standard doses of rocuronium will allow a 52.7% cost saving from the OR's IV drug budget.

This optimization model can be applied in wards where wastage cost of IV drugs is high. It will indicate which standard doses of which drug should be prepared, that will enable lowest wastage with minimal addition of manpower.