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Propofol wastage in anaesthesia: implications and environmental outcomes

Abstract
Propofol has been reported as one of the most ‘wasted’ drugs used in both human and veterinary hospitals. This article identifies the amount of propofol being discarded in the veterinary hospital and assesses the implications of doing so. Waste propofol causes both an environmental and financial burden on the hospital. It is essential that wastage in the hospital is managed correctly. It is hoped that by conducting audits such as this, the amount of wastage can be identified and minimised. Mishandling of propofol waste contaminates our waterways and soil, and its carbon footprint needs to be considered. Over-production of any drug just to be wasted uses an excess of unnecessary raw materials. Pressure is being felt by the healthcare profession to minimise the effect it has on the environment; the old ways of thinking are being challenged and changes need to be made.
The environmental impact of veterinary anaesthesia is an increasingly important topic. Some people appear to think that hospitals should ‘get a free pass’ to pollute because of the importance of the job (Rasheed and Walraven, 2023); however, in recent years demand is being placed on healthcare organisations to mitigate and adapt to climate change (Jones and West, 2019). Veterinary professionals have expressed interest in learning new ways to reduce their environmental impact and improve sustainability in veterinary clinics and hospitals (Koytcheva et al, 2021). Propofol is claimed to be the most widely dispensed and wasted drug in both human and veterinary anaesthesia. Reportedly as much as 32–49% of all propofol is wasted (Petre and Malherbe, 2020). Propofol is routinely administered to effect for induction of anaesthesia. This means that the amount drawn up is often not fully administered to the patient and will end up going to waste. This article highlights not only the amount of wastage that is occurring daily in veterinary hospitals by looking at the results of an audit but emphasises the wider implications: from the production of the drug using raw materials to the further reaching consequences wastage has on our environment.
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