Centralised propofol reconditioning procedure during COVID-19

Background and importance Because of the current pandemic, it was necessary to create an intensive care unit (ICU) in our hospital This meant an increase in the consumption of propofol and the associated supply problems It was necessary to develop a procedure to rationalise its use and administration Aim and objectives To describe the centralisation in the hospital pharmacy service of the reconditioning of propofol in bags to optimise its administration in the ICU during the COVID- 19 pandemic Material and methods The ICU contacted the pharmacy service to express the need for higher volume presentations of propofol In response, a literature review was conducted to ascertain the possibility of reconditioning propofol in higher volume containers The stability of propofol in different primary packaging materials was reviewed to select the most appropriate The risk matrix for sterile preparations from the 'Guide to good practice in the preparation of medicines in hospital pharmacy services' was applied to draw up the standard working procedure and to establish the processing conditions, stability of the preparation and storage conditions A centralised propofol reconditioning procedure (CPRP) was established in the pharmacy service: under sterile conditions, transfer the propofol into an ethylene-vinyl-acetate bag to obtain a final volume of 500 mL (10 mg/mL) (using a 0 22 μm filter if the initial packaging is glass) It was sealed, labelled and packed in a photo protective bag The established stability was 7 days refrigerated or 30 hours at room temperature A descriptive retrospective study was carried out from its implementation (20 March 2020) to the date of closure of the ICU (5 May 2020) to determine the volume of reconditioned propofol and number of patients treated Data were collected from the electronic medical record and pharmacy programmes Results During this period, 258 propofol bags were produced Reconditioned propofol was dispensed to 16 patients (median age 59 years (range 41-83);62 5% men) The median number of bags per patient was 13 5 (range 3-66) Conclusion and relevance The CPRP in the pharmacy service increases the safety of administration, allows preparation under aseptic conditions and enables the optimisation of available stock As it contains more volume, it facilitates the work and protects the nursing staff by reducing the frequency of contact with the patient