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1.
Archivos de Neurociencias ; 26(4):32-39, 2021.
Article in Spanish | Scopus | ID: covidwho-1626920

ABSTRACT

COVID-19, declared a pandemic by the World Health Organization in March 2020, has generated more than 11,000,000 cases and 500,000 deaths worldwide. The risk of operation in aerosol-generating procedures and stay in prolonged procedures has impacted neurosurgical and endovascular care, generating important implications for neuroanesthesiologists and perioperative care in general due to the risk of infection of patients and staff and the association of SARS-CoV-2 with neurosurgical patients. Objective. Present a series of recommendations based on current evidence on the implications for neuroanesthesiologists and the perioperative management of the neurocritical and neurosurgical patient during the COVID-19 pandemic. Material and methods. Bibliographic review through systematic search of keywords related to neuroanesthesiology and perioperative management of the neurosurgical and neurocritical patient during the COVID-19 pandemic. Results. The neurosurgical and neurocritical patient poses important challenges that imply the capacity for rapid response, establishment of management protocols, multidisciplinary stratification, availability of infrastructure, PPE and personnel to ensure their care. Conclusions. The role of the neuroanesthesiologist is fundamental in the organization and management of the pandemic;it must be kept safe, protected and updated in the specific considerations of the neurocritical patient in this "new normal". © 2021 Instituto Nacional de Neurologia y Neurocirurgia. All rights reserved.

2.
Revista Mexicana de Anestesiologia ; 43(4):245-250, 2020.
Article in Spanish | Scopus | ID: covidwho-829530

ABSTRACT

The disease made by the COVID-19 virus causes the infectious respiratory acute severe syndrome known as SARS-2, this virus can penetrate the central nervous system affecting neurons and glial cells, is clinically manifested as encephalitis, ischemic stroke, and even polyneuropathy. When we confront a neuroquirurgic patient with positive COVID-19 we require a fast but detailed evaluation of the general and neurological status of the sick. Every surgery in presence of a positive COVID-19 patient, must be realized with high-level protection measures while the surgery happens. The use of craniotomes and electrocautery should be minimized in order to reduce aerosol production. Transsphenoidal endonasal procedures should be avoided during the period of the pandemic. We’re based in the concense of experts made by the SNACC (Society for Neuroscience in Anesthesiology and Critical Care) to emit recommendations adapted to our environment. Endovascular therapy is a viable alternative to the intravenous trombolisis for the reestablishment of circulation. It has been observed better reperfusion in those patients who didn’t received sedation, or this was light compared with the ones who did received general anesthesia. In some cases it’s indispensable the post-surgical extubation (specially in those patients who’re infected with COVID-19), so it should be kept as deep sedation and should traslade the patient to UCI. Is important the remember that infection by COVID-19 has been shown in the principal systems, causing multi-organ damage in susceptible patients, reason of why we’ll have to look tightly after every data that takes us to think in dysfunction in small and medium term. Ethical decision making regarding which patient is a candidate to a urgent decompressive craniectomy or endovascular treatment, if more than a vase is occluded, this will have to be discussed with the treating team to not fall in therapeutic cruelty or well in the omission of a opportune treatment. © 2020, Colegio Mexicano de Anestesiologia A.C.. All rights reserved.

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