Are You Getting the Right Anesthetic?
When you’re about to have surgery, the last thing you want to worry about is the efficacy of the drugs used to put you under. But with an acute shortage of anesthesia drugs, this is a real concern in the medical field.
According to a survey by the American Society of Anesthesiologists, 98 percent of anesthesiologists in the U.S. experienced a drug shortage in 2012. The causes, says Jeff Jacobs, an anesthesiologist in Fort Lauderdale, Florida and chair of the committee on ethics for the ASA, “are myriad.” Some drugs require raw materials from developing countries – say in Africa – where there might be a civil war. Many manufacturing plants in the U.S. are dated and have limited capacity. A lot of the drugs are also generics, so pharmaceutical companies are not incentivized to produce more of them, compared to high-cost specialty drugs.
These factors have created a stressful scenario for anesthesiologists. “We’ve come very close at times [to canceling surgery], but being a big system, we can borrow from other facilities,” says Chris Snyder, the drug information pharmacist who oversees shortages and recalls for Cleveland Clinic in Ohio.
The vast majority – some 96.3 percent of doctors surveyed by the ASA – end up using alternative drugs, which may have different side effects than the routine drugs, or they import the same drugs from other manufacturers, often overseas, which may have different side effects.
David Rosen, an anesthesiologist in Chicago and president of the Midwest Anesthesiology Partners, recalls a new anesthetic used on elderly patients undergoing electroconvulsive therapy that turned out to be five times as strong as the routine drug. “We were having patients with really low blood pressure after the procedure, or they were not waking up after 45 minutes,” Rosen says. “We were lucky there was no harm done, but we were close.”