Anaesthesia and intensive care
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Anaesth Intensive Care · Aug 2001
Meta AnalysisDo anaesthetists need to wear surgical masks in the operating theatre? A literature review with evidence-based recommendations.
Many operating theatre staff believe that the surgical face mask protects the healthcare worker from potentially hazardous biological infections. A questionnaire-based survey, undertaken by Leyland' in 1993 to assess attitudes to the use of masks, showed that 20% of surgeons discarded surgical masks for endoscopic work. Less than 50% did not wear the mask as recommended by the Medical Research Council. ⋯ Policies relating to the wearing of surgical masks by operating theatre staff are varied. This indicates some confusion about the role of the surgical mask in modern surgical and anaesthetic practice. This review was undertaken to collate current evidence and make recommendations based on this evidence.
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Unselected preoperative coagulation testing is known to have low positive yield. However, no study has specifically evaluated neurosurgical patients. A retrospective study of 1211 patients having neurosurgery over a one-year period was therefore conducted. ⋯ Many patients had factors on history indicating a potential bleeding tendency, but only a prolonged aPTT, cranial surgery and the use of anti-hypertensive and anaesthetic drugs preoperatively predicted postoperative bleeding. Prolonged aPTT was predictable on history in most patients. We conclude that routine screening of all preoperative neurosurgical patients in our hospital is unnecessary.