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Preventing contamination of propofol infusions

¹ Halifax, Nova Scotia

To the Editor:

Lorenz et al.¹ examined the bacterial contamination rate of propofol syringes and infusions that were prepared according to: a) the manufacturer’s strict guidelines for aseptic handling technique; and b) an alternate method of refilling syringes using what the authors refer to as a closed loop system. While the alternate method may be more efficient and economical, it cannot be properly described as a closed loop system because the stem of the syringe plunger may come into contact with the inside of the syringe during repeated filling. This is a potential source of contamination not associated with single use. Although the authors detected no difference in bacterial contamination rates between the two methods, the sample size of 80 patients is small and we remain concerned that anesthesiologists will endanger patients and assume increased medico-legal risks if they do not follow the manufacturer’s recommended procedure.

Reference

1 Lorenz IH, Kolbitsch C, Lass-Flörl C, et al. Routine handling of propofol prevents contamination as effectively as does strict adherence to the manufacturer’s recommendations. Can J Anesth 2002; 49: 347–52.[Abstract/Free Full Text]

² Innsbruck, Austria

We welcome the comments by Drs. Hackmann and Soder on our article.¹ We agree that the stem of the syringe plunger may come into contact with the inside of the syringe during repeated filling and that this is a potential source of contamination. We wish to clearly state that the main intention of this study was to subject the manufacturer’s as yet unvalidated recommendations to a scientific study of the frequency of contamination of propofol syringes. It was in no way our intention to recommend that propofol be handled in a manner that deviates from the manufacturer’s recommendations.

Reference

1 Lorenz IH, Kolbitsch C, Lass-Florl C, et al. Routine handling of propofol prevents contamination as effectively as does strict adherence to the manufacturer’s recommendations. Can J Anesth 2002; 49: 347–52.

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