Anesthesia Equipment-Related Errors in the Operating Room: Incidence Rate and Management Methods

Abstract

Background:
Equipment-related errors in the operating room (OR) are a common source of perioperative disruption, posing significant threats to patient safety, surgical efficiency, and healthcare resources. These errors, ranging from device malfunctions to setup failures, are often preventable and underreported. This systematic review aimed to synthesize evidence on the incidence, causes, and management strategies of equipment-related errors in the OR.
Methods:
A systematic search was conducted in PubMed using MeSH terms and keywords related to "operating room", "equipment failure", and "surgical errors". Inclusion criteria were original studies (clinical trials and cohort studies) reporting quantitative data on the incidence or prevention of equipment-related OR errors. Two independent reviewers screened titles, abstracts, and full texts. Data were extracted using a standardized form, and risk of bias was assessed using appropriate tools based on study design.
Results:
Twelve studies met the inclusion criteria, including 7 cohort studies and 5 clinical trials, conducted across North America, Europe, Asia, and the Middle East. Reported incidence of equipment-related errors ranged from 5% to 21% per surgical procedure. The most common errors involved anesthesia machines, surgical instruments, and monitoring devices. Eight studies found that implementing structured interventions—particularly preoperative checklists—reduced the occurrence and recurrence of equipment errors by 30% to 60%. Secondary outcomes included surgical delays, cancellations and increased staff stress.
Conclusions:
Equipment-related errors in the OR are frequent and largely preventable. Structured safety protocols, staff training, and system-level monitoring significantly reduce their incidence. To improve surgical safety, healthcare systems should prioritize checklist adherence, reporting mechanisms, and human-centered equipment design.