Subject(s)
Anesthesia, General/adverse effects , Anesthetics/administration & dosage , COVID-19/diagnosis , SARS-CoV-2/isolation & purification , Anesthesia, General/methods , Anesthetics/adverse effects , COVID-19/complications , Child , Child, Preschool , Cohort Studies , Humans , Infant , Polymerase Chain Reaction , SARS-CoV-2/geneticsABSTRACT
PURPOSE: The aim of the present article was to briefly summarize current knowledge about the immunomodulatory effects of general anesthetics and the possible clinical effects of this immunomodulation in patients with COVID-19. METHODS: The PubMed, Scopus, and Google Scholar databases were comprehensively searched for relevant studies. FINDINGS: The novel coronavirus causes a wide spectrum of clinical manifestations, with a large absolute number of patients experiencing severe pneumonia and rapid progression to acute respiratory distress syndrome and multiple organ failure. In these patients, the equilibrium of the inflammatory response is a major determinant of survival. The impact of anesthetics on immune-system modulation may vary and includes both pro-inflammatory and anti-inflammatory effects. IMPLICATIONS: Inhibition of the development of severe inflammation and/or the enhancement of inflammation resolution by anesthetics may limit organ damage and improve outcomes in patients with COVID-19.
Subject(s)
Anesthetics/administration & dosage , COVID-19/complications , Immune System/drug effects , COVID-19/immunology , Critical Illness , Humans , Inflammation/virology , Pneumonia/virology , Respiratory Distress Syndrome/virologySubject(s)
Anesthetics/administration & dosage , COVID-19/surgery , Extracorporeal Membrane Oxygenation/methods , Lung Transplantation/methods , Respiratory Insufficiency/surgery , COVID-19/complications , COVID-19/diagnostic imaging , Disease Management , Humans , Male , Middle Aged , Respiratory Insufficiency/complications , Respiratory Insufficiency/diagnostic imaging , Transplant RecipientsABSTRACT
Electroconvulsive therapy (ECT) refers to the application of electricity to the patients' scalp to treat psychiatric disorders, most notably, treatment-resistant depression. It is a safe, effective, and evidence-based therapy that is performed with general anesthesia. Muscle relaxation is used to prevent injuries related to the tonic-clonic seizure caused by ECT. Hypnotics are administered to induce amnesia and unconsciousness, so that, patients do not experience the period of muscle relaxation, while the generalized seizure is left unnoticed. For the anesthesiologist, ECT is associated with the challenges and pitfalls that are related to informed consent, social acceptance of ECT, airway management (especially in COVID-19 patients), and the interaction between ventilation and anesthetics from one viewpoint, and seizure induction and maintenance from another. The exact mode of action of the therapy is as unknown as the optimal choice or combination of anesthetics used.