Non‐Luer neuraxial equipment and anaesthetists’ attitudes to change

Abstract

efficacy of sugammadex in patients with a creatinine clearance of less than 30 ml.min )1 [4], but impaired renal function significantly reduced the plasma clearance of sugammadex and the sugammadex-rocuronium complex [5]. Recently, it was shown that neuromuscular blockade could be re-established with 1.2 mg.kg )1 rocuronium as early as 5 min after 4 mg.kg )1 sugammadex. Onset time and duration of neuromuscular blockade block varied according to the time interval between sugammadex reversal and re-administration of rocuronium [6]. The effectiveness of a second dose of rocuronium following sugammadex has yet to be investigated in patients with renal failure.

A clinical evaluation of four non‐Luer spinal needle and syringe systems

“…A survey of anaesthetists showed a desire for the same connector to be used for both spinals and epidurals within a hospital, even at the expense of their own personal preference for equipment [12]. There is considerably more complexity regarding epidural infusion administration equipment and potential incompatibility between local anaesthetic containers, pump giving sets and the epidural catheter than there is for spinal equipment [13].…”

An evaluation of non‐Luer safety connectors for neuraxial procedures

“…Of the 205 completed procedures, 14 were not successful with the first needle ( Table 3). Ten of these (5%) were real with problems with the packaging (4), the needle shaft (4) or the needle tip (2). There was little evidence to suggest that any of the problems were solely related to the connector, with the exception of the malformed Smiths' filter needle.…”

“…When it became apparent that the deadline for spinal equipment would not be met, it was extended by one year. There still remains, though, a degree of ambivalence towards change . Many NHS trusts within the UK have chosen to defer complying with the alert until further data are available to guide their selection process, despite it being 18 months since the initial proposed implementation date for spinal equipment.…”

“…Many NHS trusts within the UK have chosen to defer complying with the alert until further data are available to guide their selection process, despite it being 18 months since the initial proposed implementation date for spinal equipment. Spinal anaesthesia requires fine motor skills and there has been concern locally that changing to new devices might increase error and harm due to a lack of familiarity with equipment or significant differences in required technique . Furthermore, the products produced by industry to comply with the NPSA alert were varied and confusing.…”