New guidance on sterile gown use during spinal anaesthesia published

20 April 2026

New international consensus guidance on the use of sterile gowns during single-shot spinal anaesthesia has been published, aiming to reduce unnecessary waste while maintaining high standards of patient safety.

The guidance advises that, in uncomplicated adult patients, the use of sterile gowns should not be considered mandatory when performing single-shot spinal anaesthesia. This recommendation follows a comprehensive review of the available evidence, which found no data to suggest that sterile gown use improves patient or staff safety for this procedure.
The Obstetric Anaesthetists’ Association has developed the consensus statement in collaboration with the Association of Anaesthetists, Royal College of Anaesthetists, Regional Anaesthesia UK, College of Anaesthesiologists of Ireland and the Australian and New Zealand College of Anaesthetists.

Despite the absence of supporting evidence, previous guidance has often recommended the routine use of sterile gowns. Most gowns are single – use plastic items that are worn briefly and subsequently disposed of by incineration, contributing to both financial cost and the environmental impact of healthcare delivery.

The guidance was developed following a structured review of the evidence and a three-stage international consensus process involving subject matter experts. It is the first clinical guidance on this topic to formally incorporate input from patient representatives.

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.”

Paul Southall, Consultant Anaesthetist and Council Member and Sustainability Lead at the Royal College of Anaesthetists, 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.”

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