Syringe pump induction may reduce propofol waste during IV anesthesia vs. manual induction

Nov 03, 2024

Published results showed syringe pump induction may be associated with less propofol waste compared with manual induction after IV anesthesia for outpatient surgery.

“In some institutions, propofol accounts for 45% of all medication waste in the OR,” Florian Windler, from the department of anesthesiology and intensive care medicine at University Hospital Bonn in Germany, and colleagues wrote in the study.

To study propofol waste reduction strategies, Windler and colleagues performed a single-center retrospective review of data from 331 outpatient surgical procedures in which patients received IV anesthesia. The study included 56 orthopedic surgeries, 167 otolaryngology surgeries, 23 maxillofacial surgeries, 24 gynecological surgeries, 18 urological surgeries and 42 general surgeries.

Overall, manual induction was performed in 117 procedures, while automated syringe pump induction (Braun Perfusor Space, B. Braun) was performed in 214 procedures.

Windler and colleagues found syringe pump induction was associated with 32.8% less propofol waste compared with manual induction. They noted syringe pump induction reduced propofol waste the most in procedures lasting 20 minutes to 60 minutes and 80 minutes to 120 minutes.

Windler and colleagues found sex, age, weight, BMI and physical status had no impact on amount of propofol waste. However, they found manual induction was associated with 27.6% more waste among patients with active substance use, while syringe pump induction was not associated with increased waste in patients with substance use.

“Manual induction using a separate syringe is associated with greater propofol waste and should be reconsidered from an environmental and economic viewpoint,” Windler and colleagues concluded.

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Windler F, et al. Orthopedics. 2024;doi:10.1016/j.bja.2024.10.002.

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