Abstract
Package insert information provided with propofol advises prompt administration following its drawing-up. This study has examined the delays which occur between drawing-up and administration of propofol in clinical practice and the incidence of bacterial contamination occurring under such conditions. Two hundred and fifty-four clinical uses of propofol were examined. Mean elapsed times (range) from drawing-up to induction were 28.8 min (1–172), and 11.6 min (1–65) from induction to culture inoculation. The delay to induction exceeded ten minutes in 68.5% of propofol uses. Sixteen cultures (6.3%) grew bacteria. Delay to induction was not associated with increased chances of bacterial growth in any of the samples. Increasing delay between induction and culture inoculation was associated with greater odds of bacterial growth, which is consistent with contamination occurring at or after induction. Whilst the manufacturers advise prompt administration, our findings show that when inadvertent delays occur, propofol remains bacteriologically safe to use under standard clinical conditions. Microbial contamination can occur at any stage, thus attention to asepsis remains important throughout the administration period.
Résumé
Le dépliant inséré dans l’emballage du propofol met en garde contre les délais d’administration une fois le produit soutiré. Cette étude porte sur les délais enregistrés entre l’aspiration du propofol et son administration en clinique, et l’incidence de la contamination bactérienne dans ces conditions. Deux cent cinquante-quatre maniements sont étudiés. Les délais entre le soutirage et l’administration sont de 28,8 min (1–172) et de 11,6 min (1–65) entre l’induction et la culture. Le délai jusqu’à l’induction dépasse dix minutes dans 68,5% des maniements. tDes bactéries se développent 16 fois dans les milieux de cultures (6,3%). Le délai jusqu’à l’induction n’est pas associé à une plus grande probabilité de croissance bactérienne, ce qui est cohérent avec la contamination qui survient à l’induction ou après celleci. Même si les manufacturiers avertissent d’utiliser le propofol sans délai, notre travail montre que lorsque des délai imprévisibles surviennent, le propofol demeure stérile sous des conditions cliniques standards. La contamination bactérienne étant possible à tous les stages du maniement, il est important de maintenir l’asepsie pendant toute la période d’administration.
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McHugh, G.J., Roper, G.M. Propofol emulsion and bacterial contamination. Can J Anaesth 42, 801–804 (1995). https://doi.org/10.1007/BF03011181
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DOI: https://doi.org/10.1007/BF03011181