New guidance on sterile gown use during spinal anaesthesia

New international consensus guidelines on the use of sterile gowns when performing single-shot spinal anaesthesia have been published today in the journal Anaesthesia by leading anaesthetic organisations from the UK, Ireland, Australia and New Zealand.  

The guidance advises that in uncomplicated adult patients, the use of sterile gowns should not be considered mandatory when performing single-shot spinal anaesthesia. The recommendations follow a comprehensive review of the evidence, which found no data to suggest that wearing sterile gowns improves patient or staff safety for this procedure.  

Despite the lack of supporting evidence, previous guidelines have suggested the routine use of sterile gowns. As most sterile gowns are made from single-use plastic and used only briefly before disposal by incineration, this practice costs money and contributes to the environmental impact of healthcare.  

This new guidance was produced jointly by the Royal College of Anaesthetists, the Association of Anaesthetists, the Obstetric Anaesthetists’ Association, Regional Anaesthesia UK, the College of Anaesthesiologists of Ireland and the Australian and New Zealand College of Anaesthetists. It was developed following a thorough review of the evidence and a three-stage expert consensus process to reach a reliable consensus involving international experts. It is the first clinical guidance on the topic to incorporate the views of patient representatives.

Paul Southall, Consultant Anaesthetist and RCoA Council Member and Sustainability Lead, said: “We hope that this guidance serves as the Gold Standard for clinicians, whilst maintaining clinical autonomy in decision making. It is important to stress that thorough hand hygiene, and the use of facemasks, sterile gloves and a sterile drape remain important in all cases.”

Cliff Shelton, Consultant Anaesthetist and Co-Chair of the Association of Anaesthetists  Safety, Standards, Environment and Sustainability Committee, said: “This guidance brings the UK, Ireland, Australia and New Zealand into line with other high-performing healthcare systems such as the USA and Canada, where gowns are not routinely used.”

Jenny Westaway, Chair of PatientsVoices@RCoA, said: “We were really pleased to be brought into this process. It was very valuable to be able to discuss this issue directly with anaesthetists, to learn more about the issue and we were glad to provide our perspectives on this as patients. We’ve been kept in the loop through the process and as a group we support this consensus statement.”  

The guidance, The use of sterile gowns for single-shot spinal anaesthesia: consensus guidelines, is published in Anaesthesia, a journal of the Association of Anaesthetists.