Background Episodes of accidental injection of medicines intended for intravenous administration into the intrathecal space have been reported worldwide, often leading to death. Since 2001, international guidelines have been issued to prevent such risks. A major recommendation is to develop a non-luer connector to use in neuraxial procedures.
Purpose To give an overview of the development and marketing of medical devices fitted with non-luer connectors.
Materials and Methods Manufacturers’ catalogues have been consulted. A literature review was conducted using the PubMed and Science Direct databases, including the following MeSH keywords ‘non luer’, ‘connectors’, ‘safety’ and ‘intrathecal’. European Health Authorities websites have been also consulted. All searches were performed between August and October 2012.
Results The United Kingdom, which has been a pioneer in guidance, was the first to implement such connectors. Five different non-luer connectors have been designed thanks to the National Patient Safety Agency (NPSA) initiative. Literature research identified few individual tests of these new devices. Some incidents such as mismatching connectors have been documented. So the NPSA has updated recommendations about introducing secure non-luer connectors. These devices are coming onto the French and Belgian market soon. To our knowledge safety connectors are not yet available in other countries.
Conclusions Non-luer connectors for intrathecal drug administration were initially launched in Great Britain. This process obviously improves the safety of intrathecal injections and leads other countries in the same way. However more advanced scientific studies of these connectors should be published. The main line of thought should be the standardisation of these connectors. Lack of standardisation is generating some hazards and supervised implementation of these medical devices is required.
No conflict of interest.
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