ABSTRACT
Coronavirus disease-2019 (COVID-19) was announced as a global pandemic by the World Health Organization on March 11, 2020 due to its rapid spread and multinational involvement. Operating room preparedness in these times should encompass increased vigilance, protective measures, and alternative procedures in an effort to mitigate the spread from a proven or suspected case. Specifically, by reducing aerosol-generating procedures as in general anesthesia, anesthesiologists can decrease exposure to patient's respiratory secretions and transmission of virus to the health-care professional and other patients. The Interoperability Standards Advisory in its advisory has also recommended regional anesthesia over general anesthesia as one of the steps that can reduce aerosol spread. Further, to restrict airway manipulation, peripheral nerve blocks (PNB) should be considered whenever possible in suspected or confirmed cases of COVID-19 undergoing surgery. PNB has the advantage of maintenance of respiratory functions, prevention of aerosolization, and so preventing viral transmission. This article explores the practical information and suggested measures for conducting PNB in COVID-19 patients with suggestions toward resource planning, clinical environment modification, equipment preparation, supply of drugs, choosing of correct personal protective equipment, safe PNB procedures, anesthesia monitoring, and postanesthetic care. By addressing these issues, infection control during anesthesia can be achieved and which is essential in the present era with emerging infection and novel pathogens such as coronavirus 2 causing the severe acute respiratory syndrome. Thus, framing a structured protocol for PNB among these patients is essential for the best perioperative outcome. © 2022 Medical Journal of Dr. D.Y. Patil Vidyapeeth ;Published by Wolters Kluwer - Medknow
ABSTRACT
Introduction: The COVID-19 pandemic along with the measure to control it like complete lockdown has affected the health-care delivery in multiple ways. Resources in the health setup were earmarked for COVID-19. All routine and nonurgent procedures were deferred. There was an overall decrease in the number of patients visiting the emergency department. However, in India, there was no major study conducted on emergency hospital admission at the time of the ongoing COVID-19 pandemic. Materials and Methods: The study was conducted in a zonal hospital as a before-and-after record-based observational study. The hospital admission data for all causes of emergency 2 months prior (i.e., from January 25, 2020, to March 24, 2020) and 2 months into the lockdown (March 25, 2020–May 24, 2020) were studied. The emergency admission during the last 2-year period in the same period was taken as a control for the study. Results: The number of emergencies reported during the year 2018, 2019 and 2020 in January 25 to March 24 were 92, 101, and 119 respectively and in March 25 to May 24 were 93, 107, and 82 respectively. There was no statistically significant difference among age, sex, and socioeconomic status of persons reported as emergencies during the studied period. There was a significant reduction by 31% in emergency hospital admissions two months before and two months after period of lockdown in the year 2020 and it varied as per subject specialty with highest reduction in emergency hospital admissions was found in orthopedic cases by 93% and no reduction in obstetric and newborn emergencies. Conclusion: The COVID-19 lockdown in India had a significant impact on the frequency as well as types of emergency admission to a large zonal hospital. The provisioning of hospital resources may need to be aligned with changing patient workload in view of COVID-19. [ABSTRACT FROM AUTHOR] Copyright of Medical Journal of Dr. D.Y. Patil University is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)