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The choice between surgical scrubbing and sterile covering before or after induction of anaesthesia : A prospective study

Jakobsson, Jan ; Sellbrandt, Irene ; Brattwall, Metha ; Jildenstål, Pether LU and Warrén Stomberg, Margareta (2017) In F1000Research 6.
Abstract

Background: Day surgery is increasing, and safe and effective logistics are sought. One part of the in-theatre logistics commonly discussed is whether surgical scrub and sterile covering should be done before or after induction of anaesthesia. The aim of the present study was to compare the impact of surgical scrub and sterile covering before vs. after the induction of anaesthesia in male patients scheduled for open hernia repair. Methods: This is a prospective randomised study. Sixty ASA 1-3 patients scheduled for open hernia repair were randomised to surgical scrub and sterile covering before or after induction of anaesthesia; group "awake" and "anaesthetised". Need for vasoactive medication during anaesthesia was primary study... (More)

Background: Day surgery is increasing, and safe and effective logistics are sought. One part of the in-theatre logistics commonly discussed is whether surgical scrub and sterile covering should be done before or after induction of anaesthesia. The aim of the present study was to compare the impact of surgical scrub and sterile covering before vs. after the induction of anaesthesia in male patients scheduled for open hernia repair. Methods: This is a prospective randomised study. Sixty ASA 1-3 patients scheduled for open hernia repair were randomised to surgical scrub and sterile covering before or after induction of anaesthesia; group "awake" and "anaesthetised". Need for vasoactive medication during anaesthesia was primary study objective. Duration of anaesthesia and surgery, theatre time, recovery room stay and time to discharge, patients and theatre nurses experiences and willingness to have the same logistics on further potential surgeries, by a questionnaire provided before discharge was also assessed. Results: The duration of anaesthesia was shorter and doses of propofol and remifentanil were reduced by 10 and 13%, respectively, in the awake group. We found still no difference in the need for vasoactive medication during anaesthesia Time in recovery area was significantly reduced in the awake group 39 (SD 15) vs. 48 SD 16) (p<0.05), but time to discharge was not different. There was further no difference in the patients' assessment of quality of care, and only one patient in the awake group would prefer to be anaesthetised on a future procedure. All nurses found pre-anaesthesia scrubbing acceptable as routine. Conclusion: Surgical scrub and sterile covering before the induction of anaesthesia can be done safely and without jeopardising patients' quality of care and possibly improve perioperative logistics. Further studies are warranted assessing impact of awake scrubbing and sterile covering on quality and efficacy of perioperative care.

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author
; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Day surgery, Operating theatre turn around, Sterile covering, Surgical scrubbing, Theatre efficacy
in
F1000Research
volume
6
article number
1019
publisher
F1000 Research Ltd.
external identifiers
  • scopus:85027246724
  • pmid:28868139
ISSN
2046-1402
DOI
10.12688/f1000research.11965.2
language
English
LU publication?
no
id
991cd7da-638d-4b44-9d88-82289893574f
date added to LUP
2020-09-27 21:07:02
date last changed
2024-05-01 18:50:24
@article{991cd7da-638d-4b44-9d88-82289893574f,
  abstract     = {{<p>Background: Day surgery is increasing, and safe and effective logistics are sought. One part of the in-theatre logistics commonly discussed is whether surgical scrub and sterile covering should be done before or after induction of anaesthesia. The aim of the present study was to compare the impact of surgical scrub and sterile covering before vs. after the induction of anaesthesia in male patients scheduled for open hernia repair. Methods: This is a prospective randomised study. Sixty ASA 1-3 patients scheduled for open hernia repair were randomised to surgical scrub and sterile covering before or after induction of anaesthesia; group "awake" and "anaesthetised". Need for vasoactive medication during anaesthesia was primary study objective. Duration of anaesthesia and surgery, theatre time, recovery room stay and time to discharge, patients and theatre nurses experiences and willingness to have the same logistics on further potential surgeries, by a questionnaire provided before discharge was also assessed. Results: The duration of anaesthesia was shorter and doses of propofol and remifentanil were reduced by 10 and 13%, respectively, in the awake group. We found still no difference in the need for vasoactive medication during anaesthesia Time in recovery area was significantly reduced in the awake group 39 (SD 15) vs. 48 SD 16) (p&lt;0.05), but time to discharge was not different. There was further no difference in the patients' assessment of quality of care, and only one patient in the awake group would prefer to be anaesthetised on a future procedure. All nurses found pre-anaesthesia scrubbing acceptable as routine. Conclusion: Surgical scrub and sterile covering before the induction of anaesthesia can be done safely and without jeopardising patients' quality of care and possibly improve perioperative logistics. Further studies are warranted assessing impact of awake scrubbing and sterile covering on quality and efficacy of perioperative care.</p>}},
  author       = {{Jakobsson, Jan and Sellbrandt, Irene and Brattwall, Metha and Jildenstål, Pether and Warrén Stomberg, Margareta}},
  issn         = {{2046-1402}},
  keywords     = {{Day surgery; Operating theatre turn around; Sterile covering; Surgical scrubbing; Theatre efficacy}},
  language     = {{eng}},
  month        = {{01}},
  publisher    = {{F1000 Research Ltd.}},
  series       = {{F1000Research}},
  title        = {{The choice between surgical scrubbing and sterile covering before or after induction of anaesthesia : A prospective study}},
  url          = {{http://dx.doi.org/10.12688/f1000research.11965.2}},
  doi          = {{10.12688/f1000research.11965.2}},
  volume       = {{6}},
  year         = {{2017}},
}