When optimising the operating theatre compromises anaesthetic safety: ambient lighting, human performance, and medication error risk.

Abstract

Blue- or green-dominant ambient lighting is increasingly used in hybrid operating theatres to optimise surgical visualisation, but it can unintentionally compromise anaesthetic safety. Emerging experimental evidence and clinical observations indicate that such lighting degrades colour discrimination and impairs recognition of International Organization for Standardization (ISO)-standard colour-coded medication labels, thereby increasing the risk of drug misidentification. This reflects broader human factors mismatch between evolving theatre design and safety standards developed for conventional white-light environments. Mitigation strategies should include localised white lighting at the anaesthetic workstation, enhanced label design, and lighting-independent technologies such as machine-readable drug labelling. A systematic re-evaluation of how theatre innovations impact the entire perioperative team is essential to future-proof anaesthetic safety in modern interventional suites.