ABSTRACT
BACKGROUND: Our hospital became a referral center for COVID-19-positive obstetric patients from 1 May 2020. The aim of our study is to illustrate our management protocols for COVID-19-positive obstetric patients, to maintain safety standards for patients and healthcare workers. METHODS: Women who underwent vaginal or operative delivery and induced or spontaneous abortion with a SARS-CoV-2-positive nasopharyngeal swab using real-time PCR (RT-PCR) were included in the study. Severity and onset of new symptoms were carefully monitored in the postoperative period. All the healthcare workers received a nasopharyngeal swab for SARS-CoV-2 using RT-PCR serially every five days. RESULTS: We included 152 parturients with COVID-19 infection. None of the included women had general anesthesia, an increase of severe symptoms or onset of new symptoms. The RT-PCR test was "negative" for the healthcare workers. CONCLUSIONS: In our study, neuraxial anesthesia for parturients' management with SARS-CoV-2 infection has been proven to be safe for patients and healthcare workers. Neuraxial anesthesia decreases aerosolization during preoxygenation, face-mask ventilation, endotracheal intubation, oral or tracheal suctioning and extubation. This anesthesia management protocol can be generalizable.
ABSTRACT
Approximately 19 628 health workers became infected during the execution of their duties, and among them, 69 clinicians died.1 The odds of transmission of acute respiratory infection to a healthcare professional is known to be 6.6 times when exposed to tracheal intubation.2 Hence, regional anesthesia (RA) as sole technique may be preferred for providing anesthesia care wherever possible in trauma patients with suspected COVID-19 infection. Besides decreasing the need for airway manipulation, RA may lower the risk of postoperative complications and reduces the length of stay in the overloaded post anesthesia care unit (PACU) and critical care units.3 Proximal humeral fracture (PHF) is a frequent occurrence in elderly patients, accounting for about 10% of all fractures in this age group.4 PHF requires emergent surgery regardless of their non-fasted state or health status and presents a unique challenge to anesthesia providers as no single brachial plexus block will likely be adequate for surgical anesthesia. Following the COVID-19 outbreak in the north of Italy, we now routinely combine ultrasound-guided IS and separate SC block (IS-SC block) (whenever possible) to allow PHF surgery to be performed entirely under RA (with patient approval) in positive, or suspected to be positive, patients. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review.