EBME Forums Forums Maintenance Technical Assistance Anaesthetic syringe pump

Thanks for the informed assistance. I have spoken to our pharmacy manger who tells me (as richard said) propofol is now generically available and relatively cheap as the patent has expired. I still need to do a costing exercise to compare intravenous with AA. IV looks better for the patient, but we need to consider the risks and look at the on-costs to see if it compares with AA. I still have some homework to do.

The Trust where I work has just taken delivery of over 30 of the Asena PK devices, I believe, although we still have a number of Graseby 3500 TCI devices in circulation so I guess we still have a stock of 3500-dedicated prefilled syringes. We should have a considerable number in the workshop soon.

I have had my hands on the PK, CC, GH and GS recently, to do acceptance and pre-acceptance checks on evalution and some software upgrades and modifications in the past. They now use the standard Asena Mk3 hardware-platform I believe, so most parts are common to all devices in the range, except for labels and software, I suppose.

I reckon that Alaris will probably do a good job of updating and introducing more patient-models to the PK software as they are clinically validated and become available. Alaris products are quite easy to configure, calibrate and check but that's my personal opinion, of course.

Plus the technical and sales support given by Alaris is very good in comparison to some of the other suppliers and manufacturers. Our Anaesthetists had a couple of B.Braun systems on evaluation a while back, consisting of a CPU and networked syringe drivers, marketed by Datex-Ohmeda just before they were snapped-up by GE, I think.

“I still need to do a costing exercise to compare intravenous with AA. IV looks better for the patient, but we need to consider the risks and look at the on-costs to see if it compares with AA.”

John

I think it's premature to be considering replacing volatile anaesthetic agent anaesthesia with intravenous anaesthesia. Both will be around for the foreseeable future.

For the past 5 years I've recommend that when replacing an anaesthetic machine/system the replacement specification reduces the number of vaporisers from three to two and includes an TIVA /TCI pump. I can think of no major savings.

Paralysed, anaesthetised patients still require to be ventilated with at least O2 and Air. In some specific areas where anaesthetists opt only to use IV anaesthesia an anaesthetic ventilator incorporating an O2/Air mixer, emergency O2 bypass and patient suction could produce savings.

Our Trust has recently purchased a number of the Fresenius 'Orchestra' TCI syringe drivers and workstations - a 'buy to save' purchase. They can use generic drugs.
We, as a dept, had no say in this contract..they just appeared in the workshop one day.
In fact, as contracts go, we wont be having much to do with these devices, just a bit of 1st-line.

Geoff, what did you think of them?

http://www.fresenius-vial.fr/uk/index.htm

Cheers
Mark

We have just commissioned 7 Asena PK's to replace
pumps supplied "on loan" by a Drug MFR for infusion of Dipivin.As the PK's can be tested the
same as the Asena CC's and GH's for "rate and
Occlusion"etc you should not have much problem
if you are already using these type of pumps.

John

Branded Diprivan comes in pre-filled special tagged syringes. The tag is "read" by a sensor on the pump as the syringe is fitted. The pump therefore knows the drug type and concentration directly from the syringe, thus eliminating a potential operator error.

Drawing up generic Propofol into a syringe requires use of a Target Controled Infusion (TCI) pump that will ignore the tag. Not all TCI pumps on the market can do this.

The stuff itself is brilliant. I've had some and you go out like a light and wake up absolutely fresh, with no fuziness. I heard however that the generic Propofol is rather less effective than the branded stuff, requiring a larger dose to achieve the correct level of anaesthesia. Consequently the savings of generic over branded aren't quite as great as the salesmen will tell you.

Marc

Thanks Richard, Bill,Adrian, Marc, I am learning quickly. I will be printing these pages off and taking them to my next meeting. (in a week)

Get involved, Mark. These things are the future. What did I think of them? I thought they were the high-point of my holiday in Taunton!

Keep the Faith, Mate (and fellow pump-boy).

BIME is currently working on two reviews, one of Diprifusor pumps, and the second on the non-Diprifusor pumps, both reports to come out this year, the first in press.
You can contact us through our TCI expert, Craig Davey, phone 01225 821387, or reply to this email

We are currently working on asena gs’s replacing all of our syringe drivers with a go live date in mayish, I assume our old 3200’s and 3500’s will go as well
I can’t remember the code for diprivan delivery units but it may be SS, but the data sets for guard rails will have to be written for propofol and other drugs used in theatres
the only probs on the loan units has been syringe clamps and these are easily replaced