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Routine handling of propofol prevents contamination as effectively as does strict adherence to the manufacturer's recommendations

[Le maniement d'usage du propofol prévient la contamination aussi effectivement que la stricte adhésion aux recommandations du fabricant]

Ingo H. Lorenz, MD^*, Christian Kolbitsch, MD DEAA^*, Cornelia Lass-Flörl, MD, Irene Gritznig, MD^*, Burkard Vollert, MD^*, Werner Lingnau^*, Patrizia L Moser, MD and Arnulf Benzer, MD DEAA^*

^* From the Departments of Anaesthesia and Intensive Care Medicine,
Hygiene and Social Medicine, and
Pathology, University of Innsbruck, Innsbruck, Austria.

Dr. Christian Kolbitsch, Department of Anaesthesia and Intensive Care Medicine, University of Innsbruck, Anichstr. 35, A-6020 Innsbruck, Austria. Phone: +43-(0) 512-504-2400; Fax: +43-(0) 512-504-2450; E-mail: christian.kolbitsch{at}uibk.ac.at

Purpose: Propofol is a potential vector of infection, because it contains no preservative. Thus, the manufacturer's specific recommendations for preparing injections or infusions go beyond the guidelines commonly used in our operating rooms for preparing other iv drugs. The purpose of the present study was to determine whether in the daily routine of an operating theatre a modified propofol handling technique can prevent contamination as effectively as do the manufacturer's handling recommendations.

Methods: A total of 160 consecutive neurosurgical patients were allocated to either Group I (manufacturer's handling recommendations: i.e., 1) disinfecting propofol vials and ampoules before filling syringes; 2) replacing empty syringes; 3) discarding all material at the end of surgery); or Group II (modified propofol handling protocol: i.e., 1) refilling empty syringes; 2) renewing only the infusion line to the patient).

Results: Total contamination rates were comparable in both groups (Group I: 14/160 (8.75%), Group II: 13/160 (8.13%) (²P=0.96). Frequency of contamination was not different between groups; either in sample 1 taken at the beginning of the procedure, (Group I: 5/80 (6.25%) vs Group II: 6/80 (7.5%); ²=0.098; P=0.76) or in sample 2, taken at the end, (Group I: 9/80 (11.25%) vs Group II: 7/80 (8.75%); ²=0.278; P=0.598).

Conclusion: We conclude that in the daily routine of the operating theatre following a modified propofol handling protocol prevents contamination of propofol syringes as effectively as does adhering to the manufacturer's specific handling recommendations. However, neither of the tested guidelines completely prevented contamination.

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