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首页> 外文期刊>Anaesthesia: Journal of the Association of Anaesthetists of Great Britain and Ireland >A simulation-based evaluation of two proposed alternatives to Luer devices for use in neuraxial anaesthesia.
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A simulation-based evaluation of two proposed alternatives to Luer devices for use in neuraxial anaesthesia.

机译：对基于神经麻醉的Luer装置的两个建议替代方案进行基于仿真的评估。

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The National Patient Safety Agency has issued a Patient Safety Alert with the aim of eliminating Luer connectors from equipment for lumbar puncture and subarachnoid injections by 1 April 2011, and from all neuraxial and regional anaesthesia equipment in 2013. B-link (UK) Ltd and InterVene Ltd have produced non-Luer connectors for neuraxial devices: the Neurax and Spinalok respectively. Using an adult spinal simulator, 59 experienced clinicians performed neuraxial procedures using these devices and reported on specific performance characteristics and overall usability. Cross-connectivity between non-Luer and Luer connectors was also examined. The median (IQR [range]) overall assessment scores (0-10 scale) of usability for the standard, Neurax and Spinalok systems were 8 (8-9 [7-10]), 6 (5-7 [0-8]) and 7 (6-8 [1-9]) for spinal procedures and 8 (8-9 [6-10]), 7 (5-8 [1-9]) and 4 (3-6 [0-9]) for epidural procedures, respectively. Both study systems scored significantly lower than standard equipment for overall performance of spinal and epidural procedures, although the performance of non-Luer devices was mostly rated 'adequate' or better. Both non-Luer connectors could cross-connect with one or more Luer connectors. Following feedback to the manufacturers, both systems have been modified and cross-connectivity apparently has been eliminated. Our results indicate that clinicians may not find non-Luer devices immediately 'user-friendly'. More importantly, some cross-connectivity with Luer devices was possible. Our findings illustrate that introducing equipment that is fully compliant with the National Patient Safety Agency alert poses a significant challenge to manufacturers and clinicians. We conclude that before introducing any non-Luer device into widespread use, independent, formal evaluation should be carried out.
机译：美国国家患者安全局已发布了《患者安全警报》，目的是在2011年4月1日之前将Luer连接器从用于腰穿和蛛网膜下腔注射的设备中以及在2013年从所有神经和局部麻醉设备中删除。B-link（UK）Ltd和InterVene Ltd生产了用于神经设备的非Luer连接器：分别是Neurax和Spinalok。使用成人脊柱模拟器，有59位经验丰富的临床医生使用这些设备进行了神经外科手术，并报告了特定的性能特征和总体可用性。还检查了非鲁尔接头和鲁尔接头之间的交叉连接性。该标准，Neurax和Spinalok系统的可用性的中位数（IQR [范围]）总体评估得分（0-10级）为8（8-9 [7-10]），6（5-7 [0-8] ）和7（6-8 [1-9]）进行脊柱手术，以及8（8-9 [6-10]），7（5-8 [1-9]）和4（3-6 [0-9] ]）分别用于硬膜外手术。两种研究系统在脊柱和硬膜外手术的总体性能方面得分均远低于标准设备，尽管非Luer器械的性能大多被评为“足够”或更好。两个非鲁尔接头都可以与一个或多个鲁尔接头交叉连接。在反馈给制造商之后，两个系统都进行了修改，并且交叉连接性显然已经消除。我们的结果表明，临床医生可能不会立即“用户友好”地找到非Luer设备。更重要的是，与鲁尔器件的某些交叉连接是可能的。我们的发现表明，引入完全符合国家患者安全局警报要求的设备对制造商和临床医生构成了重大挑战。我们得出结论，在将任何非Luer装置投入广泛使用之前，应进行独立的正式评估。

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