Infection-prevention measures against COVID-19 during anesthesia: a narrative review of current clinical literature.

ABSTRACT

The outbreak of coronavirus disease 2019 (COVID-19) has increased the risk of infection among medical staff. Anesthetists may have direct or indirect contact with COVID-19 patients' saliva droplets, blood, and other secretions in their daily work. If infection-prevention measures are not appropriate, it will not only cause individual medical staff infection, but also cross-infection among patients and other medical staff. Therefore, it is important to establish infection-control practices for COVID-19 patients during anesthesia. The aim of the present study was to review the infection-prevention measures against COVID-19 during anesthesia. Previously published studies on severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), as well as current studies on COVID-19, specifically in Wuhan, China, were analyzed. In the present study, we discuss the etiology, epidemiology, pathology, clinical manifestations, diagnosis, and treatment of SARS, MERS, and COVID-19 at first. And then we discuss preoperative preparation which include the preparation of operating room, pre-operative assessment, hand hygiene and staffing and psychological counseling. We also discuss the implementation of anesthesia, including anesthesia types, induction of general anesthesia and endotracheal intubation, postoperative recovery and patient transport. Finally, we consider the proper disposal procedure for anesthetic equipment and medical devices. COVID-19 infection can be effectively reduced by infection-prevention measures during the perioperative period.