The American Society of Anesthesiologists scaled the hills of San Francisco this year for its annual meeting, and the new products on display in the exhibit hall were a testament to innovation and ingenuity. Here are some that are likely to interest your anesthesia providers.

B. Braun | Clorotekal Spinal Anesthetic

Time is money, so B. Braun’s new spinal anesthetic, which just hit the market this fall, could be a game-changer, especially for outpatient facilities, which are always looking to get patients in and out of surgery as fast as safely possible.

Clorotekal (chloroprocaine hydrochloride) wears off in 40 to 45 minutes, instead of the usual hour-plus you’d typically get with bupivacaine. That should translate to a shorter time in the PACU and a shorter recovery time. In fact, one study found that patients given Clorotekal were ready to be discharged about 80 minutes sooner (150 vs. 230 minutes) than the bupivacaine group. Clorotekal also has a quicker onset time and has been associated with a lower urinary retention rate than other anesthetics.

My only concern: You want to be very sure that whatever surgery you’re doing is going to be quicker than the 40 minutes the anesthetic is predicted to last. Obviously, it’s inconvenient to have to convert to another anesthetic after surgery is underway.

Blink Device Company | Twitchview Neuromuscular Monitor

If, as an anesthesia provider, you’ve ever heard a stressed-out surgeon express concern about insufficient depth of a patient’s neuromuscular blockade, you’ll appreciate this innovative device.

The Twitchview Neuromuscular Monitor uses electromyography to quantify the depth of a block. It uses a single-use electrode array, which is placed on the patient’s finger. An electric current stimulates the muscles of the hand to measure the response.

The technology is impressive, and it eliminates the challenge of trying to measure twitch response when patients’ hands are tucked. It can also help with titration guidance, because you can see the pharmacokinetics of your drugs in real time. That lets you optimize titration, ultimately administer less and improve recovery times.

Cook Medical | Emergency Cricothyrotomy Kit

There’s a good chance you’ll never encounter an airway emergency so severe that you’ll need to perform a cricothyrotomy. But if you do, it’s nice to know that Cook Medical has cleverly combined 2 products into 1.

This new kit contains everything a surgeon would need to perform a surgical airway procedure. But what if no surgeon is immediately available? You can still address the emergency, because the kit also contains everything for an anesthesiologist who knows or prefers the Seldinger technique for creating an airway. Another plus: The kit is compact, easy to carry and easy to store.

Draeger | Polaris Surgical Lights

Surgical lights aren’t usually a high priority for anesthesia providers, but I was impressed by these lights from Draeger. A lot of OR lights are cumbersome and heavy, but these are light and very easy to maneuver. That’s important, because it reduces the danger in the OR as we try to navigate all the wires and other potential obstacles.

Plus, there are 4 settings, meaning you can adjust the light to provide optimal focus and illumination, depending on the surgical site. Plastic surgeons, for example, appreciate lower intensities than surgeons who are working deep in an abdominal cavity and who need more intense, “bluer” light to help differentiate blood and tissue.

There’s also the option to have an HD camera inside the lights. That’s useful for teaching and for anesthesia providers, because when there’s a lot going on, surgeons typically aren’t as communicative. This way, we don’t have to peek over the curtain to see what’s happening.

Oh, and there’s a special nod to anesthesia providers in the form of what they call an endo light — a dim light we can use to illuminate our work stations when surgeons turn the lights way down so they can see their screens better.

Karl Storz | Single-Use Intubation Scopes

No repairs, no maintenance, no waiting for disinfection. Just use it once and throw it away. That’s the pitch from Karl Storz, which expects to launch its new disposable intubation scopes in 2019. They expect image quality, durability and feel to be strong selling points, as well.

We’ll see. The image quality and cost analysis will be the keys, as far as I’m concerned. It’s true the reusable scopes tend to have a lot of maintenance issues, and they do break. But will using disposables end up being more expensive?

I think we also have to consider the environmental factor, especially in relation to climate change. How much more will we contribute to medical waste if we use disposables? Or will that be offset by the effect that the chemicals we use to clean scopes have on the environment? It can be a tough balancing act. My inclination would be to keep the disposables on hand for emergencies only, unless I see more evidence that they’re associated with lower infection rates or are better in some other way.

Pajunk | Anesthesia Trays

I was heartened to see that Pajunk is now offering regional anesthesia trays. Their needles are high quality and widely used, but they didn’t have regional kits before, a lack that could be both inconvenient and non-cost-effective, because it could mean using their needles and someone else’s tray.

The trays are a welcome addition, and so is the fact that they’re color-coded. With operating rooms being so busy, it’s easy to make a mistake and pull the wrong kit. I’ve seen cases where someone wanted to do a peripheral nerve block, but mistakenly grabbed and opened the epidural kit or spinal kit instead. It’s easy to do, but obviously very wasteful.

I also like that they don’t package a lot of unnecessary accessories. It makes for a smaller footprint, and you’re less likely to end up just throwing away half of the contents unused. Also of note: Patients keep getting bigger, and Pajunk has noticed. Instead of 3.5-inch needles, all of the new kits are equipped with 4-inch needles.

POM Medical | Procedural Oxygen Mask

POM Medical says it’s built a better mousetrap, and that just might be true. This procedural oxygen mask is a multi-port capnography mask through which you can insert most types of scopes, probes and tubes. The goal is to maintain a high level of oxygen delivery while eliminating the common, though somewhat questionable, practice of having to cut a hole in the mask.

I think this mask will be especially useful for certain populations of patients, such as the obese and those with sleep apnea. It can also save time — because you don’t have to cut that hole — and improve safety, because, as the rep points out, who knows where that little piece of plastic you just cut is going to end up. Another plus: You can hook it up to monitor for end-tidal CO2. That’s very helpful.

Raiing | iThermonitor Core Temperature Monitor

This is an innovative and interesting product, though you’d want to think carefully about which patients would benefit. It’s a non-invasive wearable thermometer that fits under the arm, monitors core temperature and wirelessly, and continuously transmits that data to a monitor. The idea is that it can be worn not just in pre-op and PACU, but also after the patient is discharged.

It’s true that the lack of continuous data can make it harder to identify normothermia ranges at individual levels, but most patients shouldn’t need continuous monitoring, especially after they go home. Nor, necessarily, should patients in the PACU, because it’s anesthesia that increases the risk of hypothermia. However, if you can identify patients who are more at risk for fever or sepsis, this could definitely help you decrease post-op complications by letting you catch potential problems earlier.

SenTec | Digital Monitoring System

SenTec has come up with an easier way to monitor arterial CO2 that could be valuable for a lot of patients. It’s non-invasive, with a sensor that can be applied to numerous validated measurement sites on the body to provide continuous data.

While it’s relatively easy to monitor blood gas in the OR, it becomes a lot more challenging when patients reach the PACU. An EKG can show respiration, but it doesn’t show end-title CO2. So, I see this system as being potentially very helpful with the management of high-risk patients, such as those with sleep apnea or patients with significantly high BMIs — especially post-operatively when patients are still given opioids.

The ability to monitor the quality of their ventilation could prevent atelectasis. Plus, elevated CO2 can affect blood pressure, which is especially concerning for patients with cardiac issues. If you’re not carefully monitoring, you may even have to rescue an airway. This promotes safety by cluing you in to ventilation issues earlier.

Teleflex | Rusch Single-Use Laryngoscope Blades

I was impressed by both the quality of the light (11,000 lux, which is very high for laryngoscopes) and the feel of these new disposable blades, which are color-coded and come in both Miller and MAC sizes. I’m also glad to see that Teleflex is taking environmental concerns seriously.

The blades, the handles and the batteries aren’t just disposable, they’re recyclable. Teleflex has partnered with a medical waste management company that will pick up the used tools, ship them out to be recycled and replenish supplies.

I think that’s great, and it could actually save money, because facilities spend a lot to dispose of waste. Will these cost less than reusable blades? I don’t know, but it’s a good way to address the environmental impact that disposables can have. OSM