In Reply:—

In response to Drs. Leighton and Mitchell’s letter to the editor about their difficulty in opening our Dantrium®Intravenous (dantrolene sodium for injection) cap center, we recognize the importance of appropriate packaging for all of our drugs, and, coincidentally, we are updating the Dantrium®Intravenous closure system, incorporating more user-friendly materials that are now available. The current Dantrium®Intravenous package has been used for 20 yr, and, during this time, we have had only a few complaints about the removal of the center of the crimped aluminum cap. Because of the global nature of this product and the requirement of compliance with many regulatory authorities, implementing this change is a lengthy process.

For the record, we do not agree with prophylactically removing the cap centers and covering the stopper with sterile tape, as suggested in the letter to the editor. This may compromise the sterility of the product. An ampule, vial, or prefilled syringe should be opened at the time of use. This recommendation is supported by the American Society of Anesthesiologists guideline entitled Recommendations for Infection Control for the Practice of Anesthesiology (2nd edition). Healthcare professionals may consult the American Society of Anesthesiologists Web site for additional information.