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Experience in Neuroanesthesia Practice from Indonesia Tertiary Hospital during COVID-19 Pandemic Era: A Descriptive Study
Journal of Neurosurgical Anesthesiology ; 34(4):472-473, 2022.
Article in English | EMBASE | ID: covidwho-2062998
ABSTRACT

Background:

Severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2) or COVID-19 pandemic was a highly contagious virus that was first reported in the city of Wuhan, China in December 2019. COVID-19 pandemic has been a challenge to the global healthcare system and healthcare professionals including Indonesia. The first case found in Indonesia was in March 2020 and there were three peaks of the case, which were in January 2021, July 2021, and February 2022. Cipto Mangunkusumo Hospital, as a tertiary level and national referral hospital, was assigned as one of the biggest COVID-19 center hospitals in Indonesia. Throughout the pandemic, several policies regarding anesthesia practice were made, including the COVID-19 screening system and surgical patient pathway. Thus, there were two exclusive negative pressure operating rooms located in a centralized COVID-19 building and an emergency unit. Many surgical procedures were performed during the pandemic, including neurosurgical cases which involved neuro anesthesia practices that needed some adjustment due to the pandemic. There are two main questions that will be addressed in this research. First, Of all patients that undergo neurosurgery procedures how many have COVID-19. Second, Of all COVID- 19 patients that undergo surgery how many of them are neurosurgery. Method(s) This study was descriptive and involved a retrospective review of data collected from patients who underwent neurosurgeries between March 2020 and March 2022. Analyzes were performed according to COVID-19 status, age, classification case, type of surgery, and type of anesthesia. Result(s) A total of 933 neurosurgery cases and 488 COVID-19 surgery cases were identified. There were 26 neurosurgery cases with COVID 19. It was about 2.7% relative to all neurosurgery cases and about 5.3% relative to all COVID 19 surgery cases. General anesthesia was conducted in all of the cases. Fifty percent of the surgery was performed in centralized COVID-19 building operating room with elective setting, following 46% of cases was performed in emergency unit. There was one case was performed in catheterization lab. The population of cases was 65.3% in adult patients and 34.7% in pediatric population, consisted of eight vascular cases, seven oncology cases, seven infection cases, three trauma cases, and one congenital case. The procedure performed were 57.6% cerebrospinal fluid diversion, 34.6% craniotomy and 7,6% debridement.We followed our hospital established local COVID-19 guideline for surgical procedures, international guidelines, and recommendations, such as SNACC, to help deciding the risk stratification and time to perform the procedures. However, we have not performed transnasal procedure, awake craniotomy, and intraoperative neuromonitoring. All safety measures and infection control protocols were implemented. Conclusion(s) Neurosurgical procedures for patient with COVID-19 are considered uncommon with respect to all COVID-19 surgery cases and all neurosurgery cases. This information can be taken into consideration when making guidelines in the pandemic era. Further research are needed to explore impact of COVID-19 to neurosurgery patients.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Journal of Neurosurgical Anesthesiology Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Journal of Neurosurgical Anesthesiology Year: 2022 Document Type: Article