Recomendaciones para la ejecución de anestesia regional no obstétrica en perioperatorio de pacientes COVID-19.

Aliste, Julián; Altermatt, Fernando; Atton, Rousmary; Bravo, Daniela Rojas; Layera, Sebastián; Miranda, Pablo; Pesce, Ítalo

doi:10.25237/revchilanestv49n03.08

Cited by 7 publications

(19 citation statements)

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“…This anesthesia modality should be performed whenever complexity of surgery and anatomic location allow, and may include the following categories: neuraxial anesthesia, ultrasound-guided peripheral nerve block and tumescent anesthesia. The equipment used for visualization, such as ultrasound probes, must be efficiently protected/isolated and disinfected after use following the COVID-19 decontamination guidelines discussed in this article [41,50,[65][66][67].…”

Section: Regional/tumescent Anesthesia With or Without Sedationmentioning

confidence: 99%

“…The anesthetist should use PPE including gown, gloves, FFP2 facial masks and surgical cap. In cases that the sedation has to be converted into general anesthesia, double gloves, facial shield and/or goggles should be added [41,46,51,53,66,69].…”

Section: Regional/tumescent Anesthesia With or Without Sedationmentioning

confidence: 99%

“…Sedation as an anesthetic technique has a higher risk of major respiratory complications as well as a major risk of contamination through aerosolized particles; therefore, the technique should be avoided when treating COVID-19infected patients and used with precaution only on healthy patients in elective cases. In cases in which the regional anesthetic technique with sedation is not sufficient, the procedure has to be converted to general anesthesia following the guidelines described in the following [41,45,66].…”

Section: Regional/tumescent Anesthesia With or Without Sedationmentioning

confidence: 99%

“…In case of general anesthesia, the patient should be preoxygenated with 100% oxygen over 5 min using a completely sealed facial mask. Manual bag ventilation should be avoided in these cases [45,66,[69][70][71].…”

Section: General Anesthesiamentioning

confidence: 99%

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Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS–COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management

Kaye¹,

Paprottka²,

Escudero³

et al. 2020

Aesth Plast Surg

145

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Background The worldwide spread of a novel coronavirus disease has led to a near total stop of nonurgent, elective surgeries across all specialties in most affected countries. In the field of aesthetic surgery, the selfimposed moratorium for all aesthetic surgery procedures recommended by most international scientific societies has been adopted by many surgeons worldwide and resulted in a huge socioeconomic impact for most private practices and clinics. An important question still unanswered in most countries is when and how should elective/aesthetic procedures be scheduled again and what kind of organizational changes are necessary to protect patients and healthcare workers when clinics and practices reopen. Defining manageable, evidence-based protocols for testing, surgical/ procedural risk mitigation and clinical flow management/contamination management will be paramount for the safety of non-urgent surgical procedures. Methods We conducted a MEDLINE/PubMed research for all available publications on COVID-19 and surgery and COVID-19 and anesthesia. Articles and referenced literature describing possible procedural impact factors leading to exacerbation of the clinical evolution of COVID-19positive patients were identified to perform risk stratification for elective surgery. Based on these impact factors, considerations for patient selection, choice of procedural complexity, duration of procedure, type of anesthesia, etc., are discussed in this article and translated into algorithms for surgical/anesthesia risk management and clinical management. Current recommendations and published protocols on contamination control, avoidance of crosscontamination and procedural patient flow are reviewed. A COVID-19 testing guideline protocol for patients planning to undergo elective aesthetic surgery is presented and recommendations are made regarding adaptation of current patient information/informed consent forms and patient health questionnaires. Conclusion The COVID-19 crisis has led to unprecedented challenges in the acute management of the crisis, and the wave only recently seems to flatten out in some countries. The adaptation of surgical and procedural steps for a riskminimizing management of potential COVID-19-positive patients seeking to undergo elective aesthetic procedures in the wake of that wave will present the next big challenge for the aesthetic surgery community. We propose a clinical algorithm to enhance patient safety in elective surgery in the context of COVID-19 and to minimize cross-contamination between healthcare workers and patients. New evidence-based guidelines regarding surgical risk stratification, testing, and clinical flow management/contamination management are proposed. We believe that only the continuous development and broad implementation of guidelines like the ones proposed in this paper will allow an early reintegration of all aesthetic procedures into the scope of surgical care currently performed and to prepare

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Section: Regional/tumescent Anesthesia With or Without Sedationmentioning

confidence: 99%

Section: Regional/tumescent Anesthesia With or Without Sedationmentioning

confidence: 99%

Section: Regional/tumescent Anesthesia With or Without Sedationmentioning

confidence: 99%

Section: General Anesthesiamentioning

confidence: 99%

See 2 more Smart Citations

Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS–COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management

Kaye¹,

Paprottka²,

Escudero³

et al. 2020

Aesth Plast Surg

145

View full text Add to dashboard Cite

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“…As members of its regional anesthesia (RA) committee, we have collected information and developed local recommendations to guide our colleagues in handling surgical procedures under RA in COVID-19 patients. 2 It is in this spirit that we wish to comment on some aspects of the suggestions made by Lie et al to discuss, clarify, and reinforce them. One of the main objectives in the management of COVID-19 patients is to protect the safety of healthcare workers.…”

Section: To the Editormentioning

confidence: 94%

Regional anesthesia during the COVID-19 pandemic: a time to reconsider practices? (Letter #2)

Aliste

Altermatt

Atton

et al. 2020

Can J Anesth/J Can Anesth

Self Cite

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Consideraciones anestésicas para el abordaje del paciente quirúrgico con COVID-19

Garzón¹,

Álvarez-Guevara²,

Castellanos-López³

2022

revsal

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Introducción: la situación actual causada por el COVID-19 demanda la implementación de nuevas técnicas en el manejo anestésico y los riesgos preexistentes en los servicios quirúrgicos. Objetivo: identificar las consideraciones anestésicas para pacientes con COVID-19 con el fin de sugerir intervenciones en el área quirúrgica. Metodología: revisión integrativa de alcance descriptivo en conjunto con el cumplimiento de los pasos metodológicos de Whittemore-Knafl y los parámetros PRISMA. Se realizó la búsqueda en las bases de datos: PubMed, BVS, Coronavirus Research Database, SCOPUS, Elsevier y SAGE. Se obtuvieron 953 artículos que, junto a un análisis crítico por CASPe, cumplieron los criterios establecidos de inclusión y exclusión. Resultados: se seleccionaron 27 artículos clasificados en: criterios de selección de técnica anestésica; anestesia general y el uso de medicamentos específicos para el manejo anestésico que disminuyan la tos y prevengan la liberación de aerosoles; manejo de la vía aérea encaminada a evitar intubaciones fallidas; anestesia regional y consideraciones de enfermería sobre la preparación de elementos y dispositivos de manera previa al ingreso del paciente al quirófano; identificación y monitorización de pacientes sintomáticos y asintomáticos durante el proceso perioperatorio. Conclusión: con respecto a la técnica anestésica, es importante priorizar el uso, en cuanto sea posible, de la anestesia regional guiada con ultrasonido. En caso de requerirse la anestesia general, es recomendable mantener las precauciones para prevenir el contagio con el virus. Para enfermería, es destacable el rol en la preparación de un entorno quirúrgico seguro, del conocimiento sobre la técnica anestésica empleada y los cuidados individualizados según las necesidades requeridas.

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Recomendaciones para la ejecución de anestesia regional no obstétrica en perioperatorio de pacientes COVID-19.

Cited by 7 publications

References 0 publications

Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS–COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management

Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS–COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management

Regional anesthesia during the COVID-19 pandemic: a time to reconsider practices? (Letter #2)

Consideraciones anestésicas para el abordaje del paciente quirúrgico con COVID-19

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