The following clinical information is intended to support clinical colleagues in mitigating the impact of this disruption and to reduce wastage:
• Standard syringes can be used instead of LoR syringes if the latter are unavailable:
o While most anaesthetists have been trained to use low-resistance syringes, significant numbers of anaesthetists use standard syringes as their preferred equipment for epidural techniques.
o Where low-resistance syringes are available, but in short supply, their use should be prioritised towards less experienced practitioners, with senior and experienced anaesthetists adopting the use of ordinary syringes in the first instance.
o Clinicians may wish to trial use of normal syringes on an epidural simulator.
• For procedures where epidural kits are used to facilitate tunnelling of a catheter, clinicians should consider either using a kit without a LoR syringe or using alternative catheters and tunnelling devices such as a large gauge venous cannula, thus preserving the syringe-containing kits for epidural use.
• As per normal practice shared decision-making principles should be used to decide on the most appropriate form of anaesthesia and/or analgesia for each patient, taking the current situation into consideration.
• As for any change in medical equipment, it will be essential good practice, and informative, to monitor and audit any complications during this period.
