Abstract:
BACKGROUND : Propofol lipid emulsion supports bacterial growth and various outbreaks of postoperative infection are attributed
to extrinsic contamination. This study’s objectives were to ascertain propofol administration practices among South African
anaesthesiologists and to determine the influence of the 2014 South African Society of Anaesthesiologists (SASA) Guidelines for
Infection Control in Anaesthesia.
METHODS : A total of 1 598 SASA members were invited to participate anonymously and 634 replies were received. Using a riskscoring
system developed from 13 questionnaire items, 542 respondents who administer propofol infusions were stratified into
Low-, Moderate-, High- and Very High-Risk groups.
RESULTS : The majority (65%) of the 542 participants who administer propofol infusions were classified as Moderate Risk, 29% as
Low Risk and 6% as High and Very High Risk. Some 61% were aware of the SASA Guidelines, of whom 47.3% had studied them.
The median risk-score of the Studied Guidelines group was significantly smaller (p < 0.001). They included a greater proportion
who were categorised as low risk (58% vs. 45%) and a lower proportion who were moderate risk (38% vs. 51%). Proportions of
high-risk individuals did not differ. Of the total 634 respondents, 247 used rubber-stoppered vials of whom 28% had studied the
SASA Guidelines; 20% of the Studied Guidelines group often/always shared vial contents between patients versus 12% of those
who had not studied them (p = 0.13). Conversely, 40% (studied group) versus 13.6% (not-studied group) often/always wiped the
diaphragm and seldom/never shared vial contents between patients (p < 0.0001). In all, 25% of the total 634 respondents often/
always pre-prepared multiple propofol syringes; 5.0% diluted propofol and often/always pre-prepared syringes.
CONCLUSION : Penetration of the SASA Guidelines was low. Differences in unsafe practices among anaesthesiologists who had read
the guidelines were statistically significant but clinically inconsequential. This highlights a need for greater publicity, emphasising
their practical importance.
