Authors:
- Dr Amy Hobbs, Consultant Anaesthetist, Anaesthetic Sustainability Lead, Royal Bolton Hospital
- Dr Paul Southall, Worcestershire Acute Hospitals NHS Trust; Chair of Environmental Sustainability Committee, RCoA
- Professor Richard Hixson, County Durham and Darlington NHS Foundation Trust; Honorary Associate Professor, University of Exeter.
- Dr Naseera Seedat, CT1, Royal Bolton Hospital
- Dr Anne Woolridge, Chief Executive Officer, Independent Safety Services Ltd
Most intravenous drugs used in anaesthesia are potentially extremely hazardous to aquatic organisms. The principles applied to propofol disposal in this article should be extended to all drugs.
Propofol is used daily in every anaesthetic department in the NHS. Both the native drug and some of its metabolites are known to be toxic to aquatic life. Furthermore, in an age of increasing Total Intravenous Anaesthesia (TIVA) use, it’s estimated that up to 50% of drawn-up propofol is wasted. Its pervasive use in the NHS, combined with its potential for ecological damage if improperly disposed of, makes propofol an important case–study for exploring the correct disposal practices for drug waste in healthcare settings and highlighting current confusion about best practice by clinicians.