The use of single‐use devices in anaesthesia: balancing the risks to patient safety*

Abstract

SummarySingle‐use devices are designed, manufactured and sold to be used once and then discarded. This paper addresses growing concerns about the quality of some devices. Single‐use devices, manufactured at a lower cost to justify their disposal, are perceived to have a lesser efficacy, which may threaten patient safety through iatrogenic harm. There is, in addition, growing scepticism about the actual risk of contracting variant Creutzfeldt‐Jakob disease and other blood‐borne diseases from reused surgical instruments. Interview data suggests that when choosing to use a single‐use device, clinicians balance concerns about the risk of infection against those about the risk of injury. However, despite reservations about induced harm and the unknown risk of an iatrogenic disease, most clinicians would want single‐use devices used on themselves and their family if they were patients.

Safety and efficacy of laryngeal mask airway Supreme versus laryngeal mask airway ProSeal: a randomized controlled trial

“…The mean oropharyngeal leak pressure with the LMA Supreme was 21 AE 5 cmH 2 O [95% confidence interval (CI) [20][21][22]. This was significantly lower than that of the LMA ProSeal, 25 AE 6 cmH 2 O (95% CI 23-27; P < 0.001).…”

“…There is an increased tendency towards single-use devices due to the awareness that protein and bacteria persist on surgical and anaesthetic instruments following the decontamination and sterilization process. The LMA Supreme has an advantage of being a single-use device and hence can reduce or even eliminate the fear that patients may contract iatrogenic infections such as variant Creutzfeldt-Jakob disease, HIV and hepatitis B or C. 20 Patients' preference for a single-use device and safety in the prevention of infective disease transmission could not be compared between the groups owing to the LMA ProSeal being reusable.…”

Coming round to recycling

“…It remains unclear whether the risk of infection is real or perceived, 16 particularly with regard to prion transmission, 17 and whether what is required is more effective sterilisation procedures rather than disposable equipment. 18 Reusing single use devices has been shown to save money, provided no adverse events occur, 19 and would also reduce packaging and clinical waste.…”

Comparative study of two laryngeal mask airways: Proseal laryngeal mask airway and supreme laryngeal mask airway in anesthetized paralyzed adults undergoing elective surgery

“…There is an increased tendency toward using single-use devices due to the awareness that protein and bacteria persist on surgical and anesthetic instruments following the decontamination and sterilization process. The S-LMA can reduce or even eliminate the fear that patients may contract iatrogenic infections such as variant Creutzfeldt–Jakob disease, HIV and hepatitis B or C[1118] which makes it a perfect option in this regard.…”