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Propofol ampoule: Take care while opening

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G. S. Chandan FRCA
Specialist Registrar
Department of Anaesthesia
University Hospital of North Staffordshire

Citation: G. Chandan : Propofol ampoule: Take care while opening . The Internet Journal of Anesthesiology. 2007 Volume 12 Number 2

To the Editor

I am reporting a cut injury which occurred whilst opening a Propofol ampoule (Fresenius Propoven 1%). In preparation to anaesthetize, the Propofol ampoule was opened which resulted in a laceration of 2 cms long and 0.5 cm in width and 0.5 cm in depth on the left thumb area (fig 1).

Figure 1: Laceration measuring 2cmsx 0.5cmx0.5cm

It was seen by a plastic surgeon, he sutured the cut and said the laceration had just missed the digital nerve, and also I could not work as an anesthetist with that wound for almost 7 days.

Injuries while breaking ampoule is not uncommon. In Parker's study (¹), the incidence of hand laceration secondary to opening glass ampoules was 6% and the prevalence of visible old hand laceration was 26%. In another study published (²), the incidence density for ampoule injury was 4.1 per person year (PPY), which was similar to needle stick injury (4.5 PPY) with health care workers. There has been a report of laceration secondary to opening Propofol ampoule which required plastic surgery (³). Ali (³) continued to experience numbness in his finger. There has also been a lot of debate on how to open Propofol ampoule (⁴, ⁵), and this was probably triggered by anecdotal evidence of Propofol ampoule injury. Palmer et al (⁶) highlighted that opening of Propofol ampoule left spikes in 51.7% which can potentially cause injury.

Although breaking an ampoule has been made easy by having markers and using flip method, there is still a risk of injury which can occasionally cause permanent disability of the hand(³). Propofol ampoule is the most commonly used large ampoule amongst anesthetists, hence we should take necessary precaution to avoid a potentially irreversible damage to the hand.

References

1. PARKER M. R. J.; Anaesthesia, 1995, vol. 50(8); 726-729 (s)

2. Journal of Medicine and Biomedical Research VOL. 3, NUM. 1, 2004, PP. 59-66 (s)

3. Ali PB. Persistent problem with Propofol ampoules .Anaesthesia 1997; 52: 1020. (s)

4. Huda W, Khan RM. Opening an ampoule? Start from a scratch. Can J Anesth 2001; 48: 715. (s)

5. Morrison WJ. Another cracking idea. Anaesthesia 1999; 54: 307-8. (s)

6. Palmer J, Ball D. Opening propofol ampoules. Anaesthesia 1998 ; 53: 416-7. (s)

This article was last modified on Fri, 13 Feb 09 13:14:46 -0600

This page was generated on Thu, 18 Mar 10 14:08:53 -0500, and may be cached.


	The Internet Journal of Anesthesiology™ ISSN: 1092-406X \| Home \| Editors \| Current Issue \| Archives \| Instructions for Authors \| Disclaimer \| Share with others \| Propofol ampoule: Take care while opening Read printer friendly Subscribe in a reader Share with others G. S. Chandan FRCA Specialist Registrar Department of Anaesthesia University Hospital of North Staffordshire Citation: G. Chandan : Propofol ampoule: Take care while opening . The Internet Journal of Anesthesiology. 2007 Volume 12 Number 2 To the Editor I am reporting a cut injury which occurred whilst opening a Propofol ampoule (Fresenius Propoven 1%). In preparation to anaesthetize, the Propofol ampoule was opened which resulted in a laceration of 2 cms long and 0.5 cm in width and 0.5 cm in depth on the left thumb area (fig 1). Figure 1: Laceration measuring 2cmsx 0.5cmx0.5cm It was seen by a plastic surgeon, he sutured the cut and said the laceration had just missed the digital nerve, and also I could not work as an anesthetist with that wound for almost 7 days. Injuries while breaking ampoule is not uncommon. In Parker's study (¹), the incidence of hand laceration secondary to opening glass ampoules was 6% and the prevalence of visible old hand laceration was 26%. In another study published (²), the incidence density for ampoule injury was 4.1 per person year (PPY), which was similar to needle stick injury (4.5 PPY) with health care workers. There has been a report of laceration secondary to opening Propofol ampoule which required plastic surgery (³). Ali (³) continued to experience numbness in his finger. There has also been a lot of debate on how to open Propofol ampoule (⁴, ⁵), and this was probably triggered by anecdotal evidence of Propofol ampoule injury. Palmer et al (⁶) highlighted that opening of Propofol ampoule left spikes in 51.7% which can potentially cause injury. Although breaking an ampoule has been made easy by having markers and using flip method, there is still a risk of injury which can occasionally cause permanent disability of the hand(³). Propofol ampoule is the most commonly used large ampoule amongst anesthetists, hence we should take necessary precaution to avoid a potentially irreversible damage to the hand. References 1. PARKER M. R. J.; Anaesthesia, 1995, vol. 50(8); 726-729 (s) 2. Journal of Medicine and Biomedical Research VOL. 3, NUM. 1, 2004, PP. 59-66 (s) 3. Ali PB. Persistent problem with Propofol ampoules .Anaesthesia 1997; 52: 1020. (s) 4. Huda W, Khan RM. Opening an ampoule? Start from a scratch. Can J Anesth 2001; 48: 715. (s) 5. Morrison WJ. Another cracking idea. Anaesthesia 1999; 54: 307-8. (s) 6. Palmer J, Ball D. Opening propofol ampoules. Anaesthesia 1998 ; 53: 416-7. (s) This article was last modified on Fri, 13 Feb 09 13:14:46 -0600 This page was generated on Thu, 18 Mar 10 14:08:53 -0500, and may be cached.
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