Year : 2008  |  Volume : 2  |  Issue : 2  |  Page : 58-61

Contamination problems with reuse of laryngeal mask airways and laryngoscopes

Stanford University School of medicine, Department of Anesthesia, California, USA

Correspondence Address:
J G Brock-Utne
Stanford University School of medicine, Department of Anesthesia, California
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Source of Support: None, Conflict of Interest: None

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Background. In many countries around the world reusable laryngeal mask airways (LMAs) are still in use despite the availability of cheap disposable LMAs. This study was designed to determine if the technique recommended in U.S. hospitals for cleaning of LMAs and laryngoscope blades is sufficient to prevent contamination. Materials and Methods . Previously used, cleaned, and autoclaved LMAs and laryngoscope blades were randomly collected from operating rooms and stained for 30 min at room temperature with erythrosinB dye. Two new and unused LMAs (negative controls) and two used and uncleaned LMAs (positive controls) were similarly stained. LMAs were rinsed with water and protein staining was evaluated by the investigators using specific criteria. In addition to the used and cleaned blades, an additional six used but not cleaned bladesacted as positive controls and two new blades were used as negative controls. Analysis of variance and two-tailed Fisher exact test were used to compare the difference in staining between various parts of the LMA. Results. Our data showed that 19/19 (100%) of the used LMAs had some degree of surface protein contamination, ranging from light to heavy staining. Moderate to heavy staining was present in 14/19 (74%) of these LMAs. The location of protein stains on the inner surface, compared to the outer surface or edgeswas statistically insignificant (P>0.05). For the laryngoscope blade portion of the study, the cleaned blades were statistically indistinguishable from the blades just removed from a patient's oropharynx. Conclusions. Cleaned, autoclaved, reusable LMAs and laryngoscope blades at a U.S.-based University hospital contained significant surface protein contamination. These results demonstrated that current cleaning methods are ineffective at removing LMA and blade surface proteins and confirm similar evidence from European hospitals. Hence reusing LMAs is not recommended. In our hospital, we now only use disposable LMAs while the laryngoscope blades follow the same cleaning protocol as before. The use of the Slater laryngoscope blade sleeves has been recommended.

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