It is now well known that the severe acute respiratory syndrome (SARS-CoV-2) originated in the Wuhan province of Hubei, China in 2019. Having spread across different countries of the world, this highly contagious disease has posed many challenges for the healthcare workers to work without endangering themselves and their patients' wellbeing. Several things are yet not clear about the virus and the presence or absence of the virus in the cerebrospinal fluid (CSF) is currently a debated topic. This article reports the perioperative management of two coronavirus disease-19 positive cases, one of whom was a pregnant patient. Their CSF samples, which were collected during the administration of spinal anesthesia, tested to be negative for viral reverse transcription polymerase chain reaction (RT-PCR) test. We wish to highlight from these cases, that during spinal anesthesia, CSF in mildly symptomatic COVID-19 cases probably does not pose a risk of transmission to the anesthesiologist. However, we suggest that due to the varied presentations of the virus, health care personnel, especially anesthesiologists have to be careful during the perioperative management of such cases.
Introduction: Since their introduction, Supraglottic Airway Devices (SADs) have established a role in both routine as well as emergency airway management of difficult airways in both children and adults. But anaesthesiologist may need to secure the airway by inserting an Endotracheal Tube (ETT) at any time. Aim: To evaluate success rate of Baska mask and Intubating Laryngeal Mask Airway (ILMA) for ETT insertion through them by conducting a prospective and randomised study. Materials and Methods: The Randomised Clinical Study was conducted in sixty American Society of Anaesthesiologists (ASA) status I-II patients scheduled for elective surgical procedures requiring endotracheal intubation through either Baska mask or ILMA. In both the groups, standard induction and insertion technique of SAD was used. Re-inforced ETT was used in the first attempt and Polyvinyl Chloride (PVC) ETT in the second attempt for intubation through both SADs. The total time for intubation, number of attempts taken to insert the SAD and ETT through it, haemodynamic response and adverse events were studied. Results: Patients in both the groups were comparable demographically with respect to sex, as a status, age and weight. Successful intubation was achieved in 33.3% (n=10/30) on first attempt through Baska mask compared to 86.7% in ILMA (n=26/30) (p=0.001). The overall intubation success rate was also lower with Baska group (56.7%; n=20/30) compared to ILMA (100%; n=30/30) (p<0.001). The haemodynamic parameters during intubation were also significantly higher in the Baska group as compared to the ILMA group. There were no differences in the other secondary outcomes. Conclusion: The first pass and overall success rate of intubation through the Baska mask were inferior to those of ILMA.
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