Maha Sekkal, Ahmed Fakri, Mustapha Bensghir
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 10
Date of Publication: 2026/10/11
Background : Anesthetic drug wastage has economic and environmental consequences, but data from lower-middle-income countries remain scarce. This study quantified intraoperative drug wastage, distinguishing avoidable from routine wastage, and estimated its annual cost in a Moroccan tertiary care center.
Material and Methods : This prospective observational study was conducted in the central operating theater of a military teaching hospital over one month (March 2023). The first two elective cases of each operating room per day were included (189 interventions, 982 syringes). For seven drugs (propofol, fentanyl, rocuronium, ephedrine, atropine, lidocaine and midazolam), prepared, administered and discarded volumes were recorded. Wastage was classified as avoidable (syringe prepared but never administered) or routine (residual drug in a partially used syringe). Costs were based on 2023 hospital acquisition prices and extrapolated to 6,000 procedures per year.
Results : Atropine was prepared in every case and never administered. Ephedrine was prepared in every case and administered in 52.9% (95% CI 45.8–59.9). Routine wastage predominated for propofol, fentanyl, rocuronium and lidocaine, reflecting a mismatch between vial size and dose. The estimated annual cost of wastage was 244,097 Moroccan dirhams (MAD) (≈24,410 USD); propofol (40.8%) and fentanyl (18.0%) accounted for 58.9% of this loss. Avoidable wastage of emergency drugs cost approximately 30,000 MAD per year.
Conclusions : Most anesthetic drug wastage in this setting was preventable. On-demand preparation of emergency drugs for stable elective patients and procurement of smaller presentations of propofol, lidocaine and fentanyl could reduce both costs and the environmental burden of anesthesia.
Anesthetics, intravenous; cost analysis; drug costs; medical waste; operating rooms; sustainability
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