The following upgrades, concepts and innovations are some of the more exciting new products on the market for your surgical facility. As you'll see, there is representation from the areas of patient monitoring, warming devices, testing and invasive supplies, anesthesia machines and automated record technology. My personal interest lies with those companies that have chosen to advance the science of data collection, without which it would be more difficult to take outcomes studies and evidence-based medicine to the next level. But the latest devices and products go beyond collecting data. From workstations and monitors worthy of capital budget approval to petty cash purchases for more simple solutions to common problems, this year's collection has it all. Some may prove to be more useful than others, but all are worthy of your consideration. Here's a review of just a few of the anesthesia products that have been recently introduced.

- Adam F. Dorin, MD, MBA

Airpal Patient Transfer Systems
Raid Airway Management Positioner
(800) 633-4725
www.airpal.com
List price: Not disclosed

The company says this ramp enhances ventilation, can help position patients for direct laryngoscopy and is suited for bariatric patients. I can see how this positioner could be an invaluable adjunct to difficult airway management cases.

The difference between a difficult and traumatic airway placement and the simple, quick placement of a secure airway is sometimes a simple matter of proper head or neck positioning.

Anecare
QED-100T Emergence Device
(801) 977-8877
www.anecare.com
List price: $39

A tool for emergence airway management in at-risk cases, the device promises to enhance the performance of the inhaled anesthetics isoflurane, sevoflurane and desflurane by improving the predictability and speed of emergence when activated in the anesthesia breathing circuit. For such a little piece of equipment, the physiological consequences of the QED-100T Emergence Device are quite complex. This product may reduce emergence times and facilitate a quicker wake-up and extubation under certain conditions. It may be well suited for an academic or teaching setting.

Aspect Medical
BIS Vista
(800) 442-7688
www.aspectmedical.com
List price: $8,500

The BIS Vista standalone consciousness monitor offers bispectral index (BIS) monitoring with enhanced, user-friendly features and a full color, 4-inch-by-5.25-inch LCD display that has touchscreen navigation. USB ports offer system expandability and real-time updates, says the company. You'll also get increased case storage and enhanced processing power from the 4.5-lb. monitor that measures 7.5 inches wide, 8 inches high and 6 inches deep, says Aspect Medical. Its longer battery life gives you backup power for 45 minutes at full operation and takes six hours to recharge, says the company.

Bair Hugger
Lithotomy Underbody Blanket
(800) 733-7775
www.bairhugger.com
List price: Not disclosed

The blanket is positioned on the table before the case begins and is designed to warm the patient during procedures involving the lower extremities and abdominal, peritoneal and pelvic cavities. This is a good concept. It's important to ensure a warm patient during prolonged cases involving a variety of patient positions that make conventional warming difficult. Depending on the price negotiated per blanket, this product could be a good investment toward better patient care.

Baxter
Generic Ondansetron
(888) 229-0001
www.baxter.com
List price: Not disclosed

I use this anti-emetic. It works just as well and is less expensive than name brand doses. You can't beat that combination. The FDA does a good job in ensuring the quality and bio-equivalence of generics, so I'm a big fan of the generic drug industry, as least as it applies to prescription drugs.

B. Braun
Stimuplex HNS 12 Peripheral
Nerve Stimulator, Introcan Safety IV Catheter
(610) 691-5400
www.bbraunusa.com
List price: Not disclosed

The Stimuplex HNS 12 peripheral nerve stimulator has a variety of pulse duration choices for locating nerves on patients with ploy-neuropathies or for targeting sensory nerves. Longer pulse durations can be used with the Stimuplex Pen to map nerves without penetrating the skin. This stimulator may provide superior performance in facilitating quick and effective nerve blockade. Like all products of its kind, its value for each anesthesia provider will be revealed through clinical use. For departments looking to add or replace a nerve stimulator, this product may be a good investment. B. Braun also introduced the Introcan Safety IV Catheter. It's the only safety catheter I have ever worked with that's actually superior to the plain Jelco-type IV catheter.

Cincinnati Sub-Zero Products
Gelli-Roll
(513) 772-8810
www.cszmedical.com
List price: $725 to $1,000

Cincinnati Sub-Zero Products is offering a buy-one, get-one-free deal with the purchase of all Gelli-Rolls. Well, almost. The company combined the benefits of two products into one by encapsulating a warming blanket with Akton gel. Attach the Gelli-Roll to one of the company's warming systems and you'll achieve temperature-warming management and tissue-pressure reduction with one reusable product. This looks like a promising device.

Criticare Systems
nGenuity 8100E1
(800) 458-4615
www.csiusa.com
List price: $6,600

My favorite aspect of this patient monitor is the big, bright display. Its numbers are large and easy to read, and the company boasts about its user-friendly features, simplified menus and dedicated function keys. Criticare Systems says the monitor mounts easily to walls and roll stands, and comes standard with configurations for ECG, NIBP, DOX, SpO2, HR, temperature, respiration, ETCO2 and nurse call connection. This looks like a great product and likely worth the investment.

Datascope
Accunet Charting
(201) 391-8100
www.datascope.com
List price: Not disclosed

I'm a big fan of the anesthesia electronic medical record concept - something that's not only approaching the point of legislative mandate, but also necessary for improving efficiency, minimizing errors, and facilitating data storage and applications for outcomes studies. This system links patients' vital signs data to EMRs to improve efficiency and accuracy in operative reporting. The company says that once recorded, patient records can be accessed using a PDA, pager, mobile phone or the Internet.

Delphi Medical
VariFit Contour Disposable Tourniquet Cuffs
(800) 933-3022
www.delfimedical.com
List price: Not disclosed

These disposable tourniquet cuffs meet the 2007 AORN Standards, Recommended Practices and Guidelines and are wider than standard cuffs, allowing for blood flow to be stopped at lower tourniquet pressures. The company says the cuff's pivoting straps and a secondary fastener secure them around limbs of varying contour. According to Delphi, they come in the following models: arm, thigh and lower leg, single port, dual port and a dual-bladder Bier Block cuff.

Draeger Medical
Infinity TeleSmart
(800) 437-2437
www.draeger.com
List price: Not disclosed

Draeger Medical's latest compact monitor lets you view patient information at the patient's side. The monitor's color display shows ECG readings for all monitored leads, heart rate, SpO2 and electrode status as well as patient demographics to confirm the patient's identification before treatment. The color display combines with built-in alarms to both alert staff and provide information for responding quickly to adverse events. Throw in the built-in rechargeable battery and you've got a nice device. If you're in the market for this type of product as a replacement - or for a new facility - consider this a good choice.

DRE
Waveline Plus
(800) 477-2006
www.dremed.com
List price: Not disclosed

Another addition to the vital signs monitor market, DRE's Waveline Plus features a 10.4-inch, high-resolution color display. The device is equipped for a maximum of seven parameters, including pulse oximetry, EKG, noninvasive blood pressure and end tidal CO2. Depending on your budget, this may not be a must-have product, but I believe it would be a great addition to your clinical monitoring set-up.

GE Healthcare
Aespire 100
(800) 345-2700
www.gehealthcare.com
List price: Not disclosed

GE Healthcare continues its line of anesthesia workstations with the Aespire 100. The platform has the same features of the Aespire 7900: A small footprint designed specifically for use in surgery centers and the Advanced Breathing System, which allows for fresh gas to be introduced proximal to the inspiratory check valve, meaning the system has 2.7 liters of volume and fast reaction times to changes in fresh gas concentration. The primary differences between both platform models are the modes of ventilation available. While both ventilators are microprocessor-controlled and feature a multiple-breath ascending bellows, the 7100 ventilator - featured on the Aespire 100 - is available with volume-control ventilation and pressure mode, pressure support ventilation with apnea backup (PSVPro) and synchronized intermittent mandatory ventilation (SIMV). This is a nice system, and one suited for facilities performing a high volume of complex cases.

Havel's
Extra-long Accutarg Needles
(800) 638-4770
www.havels.com
List price: Not disclosed

Havel's has always provided a variety of needle sizes, allowing practitioners to choose the appropriate needle for individual procedures. Now they've added extra long AccuTarg Quincke needles to their line, available in 53 sizes from 12 inches to 3.5 inches. These are good products. The availability of the company's Sprotte needles and other relatively atraumatic, small needle designs is key to any good regional anesthesia cart.

Hospira
iSecure syringe
877-9HOSPIRA
www.hospira.com
List price: Not disclosed

Hospira says its new disposable syringe comes pre-filled and ready to use in standardized, clearly labeled, unit-of-use barcoded packages. The needle-free and latex-free design is currently available for ondansetron injection. These syringes are a good concept that must be integrated with a pharmacy inventory. Clearly, the addition of barcoding and RFID drug-tracking technology is necessary to reach the next level in minimizing drug errors, waste and theft in the clinical setting.

Inditherm Medical
Operating Room Matress
44 (0)1709 761000
www.inditherm.com/medical
List price: Not disclosed

This warming system runs silent at the cost of powering a light bulb, claims Inditherm Medical, letting you keep your operating tables warm from the first case to the last. That's a great idea with the current need for energy conservation. The patented flexible polymer technology and large surface area are said to effectively warm patients while helping prevent pressure injuries. The Operating Room Mattress is X-ray translucent, anti-static, latex-free and reusable. The system comes in sizes ranging from pediatric to adult.

Luminetx
VeinViewer
(866) 789-7281
www.veinviewer.com
List price: Not disclosed

Some physicians and nurses might think they have super powers. This device is as close to the real deal as they're going to get. Through the use of near-infrared light, VeinViewer projects subcutaneous veins onto the skin in real time, letting staff "see" through the skin to target accessible veins. It takes the guesswork out of IV starts, avoids the need for multiple sticks, and reduces stress levels of both patient and clinician. The device works on all body types, and is particularly useful for locating accessible veins in obese patients. This could be a great technological development.

Kawasumi Laboratories
Gravity IV Administration Sets
(800) KAWASUMI
www.kawasumiamerica.com
List price: Not disclosed

Kawasumi Laboratories throws its hat into the outpatient arena with two gravity IV sets designed specifically for ambulatory surgery. The IV-026N is a 10-drop set measuring 120 inches, a length that the company says allows for flexibility when administering IVs while also eliminating the need for extension sets. A more basic model, the IV-027N, is a 20-drop, 107-inch set with two needleless Y-sites.

King Systems
Airtraq, King LTS-D
(800) 642-5464
www.kingsystems.com
List price: Not disclosed

King Systems now offers its Airtraq disposable optical laryngoscope in a size appropriate for patients with a mouth opening as small as 16mm. The Airtraq was previously only available in a regular size. Both the regular and small sizes can accommodate standard endotracheal tubes, offer a high definition optical system and have built-in anti-fog systems and light sources. The company also introduced the King LTS-D, a latex-free supraglottic airway. This device has centimeter depth markings for minimal trauma to the airway during insertion.

)Masimo
Rainbow SET
(949) 297-7000
www.masimo.com
List price: Not disclosed

Masimo's Rad-57 and Radical-7 patient monitors feature the company's latest development in monitoring capabilities: Rainbow SET Pulse CO-Oximetry. The technology employs wavelengths of light to measure carbon monoxide and methemoglogin. This monitor lets you detect within seconds unsuspected CO poisoning as a result of sleep apnea, heavy smoking, too much benzocaine or other factors. The sensors are said to minimize noise, improve identification of the desired physiological signals and work if the patient moves.

Mercury Medical
air-Q
(800) 237-6418
www.mercurymed.com
List price: Not disclosed

Any reasonably affordable product that adds to airway safety is a major plus. This is one of those devices. The air-Q, a disposable laryngeal airway, has a color-coded connector that can be removed to intubate the patient if needed - without ever compromising the airway. The air-Q's shape directs standard endotracheal tubes toward the laryngeal inlet while the device's mask tip resembles the shape of the posterior pharynx, helping eliminate the bending and kinking of the tubes. The mask's inside surface is ridged to enhance mask sealing.

Salmon Medical Innovations
Dentasafe
(866) 268-3376
www.salmonmedical.com
List price: Pack of two, $2.99

Afraid of having patients walk out of your facility looking like hockey players who've lost a few fights? These guards are latex-free foam pieces that adhere to the laryngoscope blade to help keep your anesthesia provider from damaging patients' teeth. Adhered on the top and underside of the blade, they're thin enough to act as a cushion, but not so thick that they get in the way. Damaging teeth may not be a major concern of anesthesia providers, but it is always a potential problem. At these affordable rates, why not purchase a few guards to have some handy?

Sonosite
MicroMaxx
(888) 482-9449
www.sonosite.com
List price: $35,000 to $75,000

The MicroMaxx portable ultrasound system offers unique multi-beam imaging technology that improves image resolution. Seeing the nerve helps prevent nerve damage and extra sticks during regional anesthesia. The system can now be used for abdominal applications and is compatible with tranducers ranging from high-frequency linear to multi-plane transesophageal. Sonosite emphasizes the device's five-year warranty.

Soothing Scents
QueaseEASE
(888) 393-7330
www.soothingscents.com
List price: $12

We all know that PONV is a major patient complaint following surgery. Soothing Scents says QueaseEASE contains 100 percent pure and natural, therapeutic-grade essential oils that relieve post-op queasiness when patients inhale their aromas. I'd like to see more studies that prove this therapy's efficacy, but it certainly has potential. It's affordable. Why not trial the product to see if it works?

Stryker Instruments
SmartPump
(800) 253-3210
www.stryker.com
List price: Not disclosed

The SmartPump tourniquet system is designed to increase the cuff's inflation rate with simple controls that require little staff training. An internal battery features safety backup for up to five hours. The system records real-time patient data and is wired for OR connectivity.

Stryker Instruments
Snap II
(800) 253-3210
www.stryker.com
List price: Not disclosed

Stryker's Snap II consciousness monitor analyzes both low- and high-frequency EEG in real time. It provides an all-new objective metric, the SNAP index, which measures the state of the brain and assesses level of consciousness. You can set visual and audible alerts according to your preferences.

Sunnex
Task Lamps
(800) 445-7869
www.sunnexonline.com
List price: Not disclosed

Good lighting is always hard to come by, so I like this product. Sunnex has improved upon cumbersome clip-on lights by offering a customizable lamp that can be mounted on the anesthesia carts with gooseneck or articulating arms. These Task Lamps illuminate work areas with a 20-watt halogen bulb that has more than 2,000 hours of life.