Rational Utilization of Sugammadex Through Quantitative Twitch Monitoring: A Process Improvement Project at a Large...

Area of Science:

• Anesthesiology
• Pharmacoeconomics
• Patient Safety

Background:

• Sugammadex is a standard for neuromuscular blockade reversal, increasing pharmacy expenses.
• High costs necessitate strategies for optimizing sugammadex utilization.
• Adherence to FDA dosing and cost reduction are key concerns.

Purpose of the Study:

• To evaluate the impact of using 75 mg sugammadex aliquots versus 200 mg vials.
• To assess the effect of introducing quantitative neuromuscular monitoring.
• To determine if these changes improve cost-effectiveness and adherence to guidelines.

Main Methods:

• Retrospective analysis of a process improvement initiative.
• Comparison of sugammadex use across three phases: baseline, 75 mg aliquots, and 75 mg aliquots with quantitative monitoring.
• Evaluation of average dose per case, monitoring practices, and safety events.

Main Results:

• Average sugammadex dose per case decreased by 55.4 mg with 75 mg aliquots.
• Dose increased by 10.8 mg after implementing quantitative monitoring.
• Improved documentation of neuromuscular blockade with no increase in safety events.

Conclusions:

• Compounded sugammadex aliquots, quantitative monitoring, and education enhance reversal practices.
• This approach effectively reduces healthcare costs associated with neuromuscular blockade reversal.
• Optimized sugammadex administration improves both economic and clinical outcomes.