Surgical Masks Affect the Peripheral Oxygen Saturation and Respiratory Rate of Anesthesiologists

Abstract

Background: Surgical masks (SMs) protect medical staff and reduce surgical site infections. Extended SM use may reduce oxygen concentrations in circulation, causing hypoxia, headache, and fatigue. However, no research has examined the effects of wearing SMs on oxygenation and physical discomfort of anesthesiologists.

Methods: An electronic questionnaire was established and administered through WeChat, and a cross-sectional survey was conducted to determine SM use duration and related discomfort of operating room medical staff. Then, operating room anesthesiologists were enrolled in a single-arm study. Peripheral blood oxygen saturation (SpO2), heart rate, and respiratory rate were determined at different times before and after SM use. Shortness of breath, dizziness, and headache were subjectively assessed based on the visual analog scale (VAS) scores.

Results: In total, 485 operating room medical staff completed the electronic questionnaire; 70.5% of them did not change SMs until after work, and 63.9% wore SMs continuously for more than 4 h. The proportion of anesthesiologists was the highest. After wearing masks for 4 h, the shortness of breath, fatigue, and dizziness/headache rates were 42.1, 34.6, and 30.9%, respectively. Compared with other medical staff, the proportion of subjective discomfort of anesthesiologists increased significantly with prolonged SM use from 1 to 4 h. Thirty-five anesthesiologists completed the study. There was no difference in anesthesiologist SpO2, heart rate, or respiratory rate within 2 h of wearing SMs. After more than 2 h, the variation appears to be statistically rather than clinically significant-SpO2 decreased (98.0 [1.0] vs. 97.0 [1.0], p < 0.05), respiratory rate increased (16.0 [3.0] vs. 17.0 [2.0], p < 0.01), and heart rate remained unchanged. As mask use duration increased, the VAS scores of shortness of breath, dizziness, and headache gradually increased.

Conclusion: In healthy anesthesiologists, wearing SMs for more than 2 h can significantly decrease SpO2 and increase respiratory rates without affecting heart rates.

Keywords: anesthesiologists; heart rate; peripheral oxygen saturation; respiratory rate; surgical mask.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Yang, Fang, Liu, Liu, Huang, Wang and Qi.

Figures

Figure 1

Occupation and gender of operating room medical staff who participated in the electronic questionnaire (A,B).

Figure 2

The duration of continuous surgical mask use and the frequency of mask changes on working days: among all participants (A,B) and between different occupations (C,D).

Figure 3

Subjective discomfort associated with continuously wearing surgical masks for 1 and 2 h: among all participants (A,B) and between different occupations (C,D).

Figure 4

Subjective discomfort associated with continuously wearing surgical masks for 3 and ≥4 h: among all participants (A,B) and between different occupations (C,D).

Figure 5

Mean O2 content (A), SpO2(B), heart rate (C), and respiratory rate (D) by time point. *P < 0.01, **P < 0.01, vs. the value of before SM use (T1). ##P < 0.01, vs. the value of immediately after SM use (T2).

Figure 6

VAS scores for shortness of breath (A), dizziness and headaches (B) by time point. **P < 0.01, vs. the value of before SM use (T1). ##P < 0.01, vs. the value of immediately after SM use (T2).