Guidelines: Anaesthesia in the context of COVID-19 pandemic

Velly, Lionel; Gayat, Étienne; Quintard, Hervé; Weiss, Emmanuel; Jong, Audrey De; Cuvillon, Philippe; Audibert, Gérard; Amour, Julien; Beaussier, Marc; Biais, Matthieu; Bloc, Sébastien; Bonnet, Marie; Bouzat, Pierre; Brezac, Gilles; Dahyot‐Fizelier, Claire; Dahmani, Souhayl; Queiroz, Mathilde De; Maria, Sophie Di; Ecoffey, Claude; Futier, Emmanuel; Geeraerts, Thomas; Jaber, Haithem; Heyer, Laurent; Hoteit, Rim; Joannès-Boyau, Olivier; Kern, Delphine; Langeron, Olivier; Lasocki, Sigismond; Launey, Yoan; Saché, Frédéric Le; Lukaszewicz, Anne Claire; Maurice-Szamburski, Axel; Mayeur, Nicolas; Michel, Fabrice; Minville, Vincent; Mirek, Sébastien; Montravers, Philippe; Morau, Estelle; Muller, Laurent; Muret, Jane; Nouette‐Gaulain, Karine; Orban, J.-C.; Orliaguet, Gilles; Perrigault, Pierre François; Plantet, Florence; Pottecher, Julien; Quesnel, Christophe; Reubrecht, Vanessa; Rozec, Bertrand; Tavernier, B.; Veber, Benoît; Veyckmans, Francis; Charbonneau, Hélène; Constant, Isabelle; Frasca, Denis; Fischer, Marc-Olivier; Huraux, Catherine; Blet, Alice; Garnier, Marc

doi:10.1016/j.accpm.2020.05.012

Cited by 67 publications

(97 citation statements)

References 64 publications

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“…[7][8][9][10] To provide anesthetic and surgical care to COVID-19 patients, healthcare workers have to reorganize surgical platforms, personal protective equipment protocols, and in-hospital patient trajectories to prevent viral spread to healthcare workers and other patients. [11][12][13][14][15] Documenting the needs for, and variety of, surgical procedures in this population is paramount in order to estimate the accrued risk for the patients.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Outcomes in Surgical COVID-19 Patients: A Multicenter Cohort Study

Carrier

Amzallag²,

Lecluyse

et al. 2020

Preprint

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BackgroundData on postoperative outcomes of the COVID-19 patient population is limited. We described COVID-19 patients who undergone a surgery and the pandemic impact on surgical activities.MethodsWe conducted a multicenter cohort study between March 13 and June 19 2020. We included COVID-19 patients who underwent surgery in nine centres of the Province of Québec, the Canadian province most afflicted by the pandemic. We also included suspected COVID-19 (subsequently confirmed not to have COVID-19) patients and patients who had recovered from it. We collected data on baseline characteristics, postoperative complications and overall surgical activities performed in participating centres. Our primary outcome was 30-day mortality. ResultsWe included 44 COVID-19 patients, 18 suspected patients, and 18 patients who had recovered from COVID-19 at time of surgery. Among the 44 COVID-19 patients, 31 surgeries (71%) were urgent and 16 (36%) were major. In these patients, pulmonary complications were frequent (25%) and 30-day mortality was 15.9%. This mortality was higher in patients with symptoms (23.1%) compared to those without symptoms (5.6%), although not statistically significant (p = 0.118). Of the total 22 616 cases performed among participating centres during the study period, only 0.19% had COVID-19 at the time of surgery. Fewer procedures were performed during the study period compared to the same period in 2019 (44 486 cases).Conclusion In this study, postoperative 30-day mortality in COVID-19 patients undergoing surgery was 15.9%. Although few surgeries were performed on COVID-19 patients, the pandemic impact on surgical activity volume was important. Trial registrationClinicalTrials.gov Identifier: NCT04458337

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Section: Introductionmentioning

confidence: 99%

Postoperative Outcomes in Surgical COVID-19 Patients: A Multicenter Cohort Study

Carrier

Amzallag²,

Lecluyse

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…General anaesthesia is an aerosol generating procedure and there is concern about putting theatre staff and patients at risk. 16 , 17 Regional and local anaesthesia therefore offers the theoretical benefit of minimising potential transmission by maintaining a patient’s own respiratory effort, avoiding airway manipulation and allowing patients to wear a mask during the procedure. The majority of cases in our series underwent surgery under GA and there appears to be no increased risk of acquiring COVID-19 in patients who received a GA compared to regional or local anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

Is it safe to restart elective day-case surgery? Lessons learned from upper limb ambulatory trauma during the COVID-19 pandemic

Trowbridge

Wignadasan

Davenport

et al. 2020

Journal of Clinical Orthopaedics and Trauma

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Background: The COVID-19 pandemic has impacted on the provision of elective and trauma orthopaedic surgery worldwide with millions of operations cancelled. The risk of patients developing COVID-19 after undergoing ambulatory procedures in hospitals is unknown. This paper aims to investigate the risk of developing COVID-19 from day-case and overnight stay upper limb procedures during the peak of the pandemic in London, and to discuss the implications for the safe management of elective hand and upper limb patients in the coming months. Methods: 56 patients underwent emergency trauma upper limb procedures as a day case or with a single overnight stay from 1st March to May 31, 2020 at two central London hospitals that were also key players in the pan-London COVID response. Data was collected retrospectively from clinical and theatre records. Patients were contacted post-operatively and answered a structured questionnaire, including whether patients had experienced any of the symptoms suggestive of COVID-19 in the 14 days prior or 30 days following surgery. Results: Of 56 patients, one patient reported COVID-19 symptoms, which were minor and did not require hospitalisation. Five patients experienced minor post-operative complications such as stiffness and scar hypersensitivity; one patient had a superficial wound infection. The mean age was 46 years (20e90) with 68% patients ASA I, 25% ASA II and 4% ASA III. 9% had LA, 30% a regional block and 61% had a GA. The most common operation was a distal radius open reduction and internal fixation. The average time spent in hospital was 11 h (3e34 h) and 12 patients required an overnight stay. The median length of face-to-face follow up was 38.5 days. Conclusion: Our study suggests that, with appropriate precautions, elective upper limb ambulatory surgery can be safely restarted with a low risk of contracting COVID-19 or its complications.

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“…All health care providers in the theatre should wear personal protective equipment (PPE). They should first have appropriate hand hygiene and then wear a fit N95 respirator, face protector shield, gown, and gloves (Velly et al 2020 ).…”

Section: Preoperative Evaluationmentioning

confidence: 99%

Insights of COVID-19 pandemic impact on anesthetic management for patients undergoing cancer surgery in the National Cancer Institute, Egypt

Elsabeeny

Dayem

Rabea

et al. 2020

Ain-Shams J Anesthesiol

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New corona virus disease COVID-19 is a pandemic outbreak viral infection that is highly contagious. The disease can affect any age groups. Majority of patients show mild or no symptoms. Immunocompromised patients and patients with co-morbidities are more vulnerable to have more aggressive affection with higher rate of complications. Thus, cancer patients carry a higher risk of infection. Diseased patient can transmit infection throughout the disease course starting from the incubation period to clinical recovery. All healthcare workers contacting COVID-19-positive patients are at great risk of infection, especially the anesthesiologists who can be exposed to high viral load during airway manipulation. In the National Cancer Institute of Egypt, we apply a protocol to prioritize cases where elective cancer surgeries that would not affect patient prognosis and outcome are postponed during the early phase and peak of the pandemic till reaching a plateau. However, emergency and urgent surgeries that can compromise cancer patient’s life and prognosis take place after the proper assessment of the patient’s condition. Aim This review aims to spot the management of cancer patients undergoing surgery during the COVID-19 pandemic in the National Cancer Institute, Egypt.

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Guidelines: Anaesthesia in the context of COVID-19 pandemic

Cited by 67 publications

References 64 publications

Postoperative Outcomes in Surgical COVID-19 Patients: A Multicenter Cohort Study

Postoperative Outcomes in Surgical COVID-19 Patients: A Multicenter Cohort Study

Is it safe to restart elective day-case surgery? Lessons learned from upper limb ambulatory trauma during the COVID-19 pandemic

Insights of COVID-19 pandemic impact on anesthetic management for patients undergoing cancer surgery in the National Cancer Institute, Egypt

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