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Anesthesia Procedure Outlined for Emergency Surgery in COVID-19 Patients

Fast induction of anesthesia with adequate muscle relaxation recommended to prevent cough

TUESDAY, March 24, 2020 (HealthDay News) — In a letter to the editor published online Feb. 25 in Surgical Infections, recommendations are presented regarding anesthesia procedures for emergency operations in patients with suspected or confirmed coronavirus 2019 (COVID-19).

Xianjie Wen, from the First Affiliated Hospital of Jinan University in Guangzhou, and Yiqun Li, from the Second People’s Hospital of Foshan City, both in China, outline a standardized procedure for surgical anesthesia for COVID-19 pneumonia patients.

The authors note that all relevant personnel need continuous training and updating with respect to SARS-CoV-2. For patients with suspected or confirmed COVID-19 pneumonia, elective surgical procedures should be cancelled, while emergency operations should take place in a negative pressure operating room. In these patients, general anesthesia or monitoring anesthesia should be used. Three-level protection requirements should be adopted to protect anesthesiologists. Anesthetic equipment, appliances, and drugs must be specifically designated. To prevent cough, fast induction of anesthesia with adequate muscle relaxation is recommended. Muscle relaxation drugs, intravenous general anesthetic, and opioids should be administered in that order to prevent cough. Mask pressurization ventilation should ideally be avoided before the patient loses consciousness. After surgery, the operating room must be disinfected. Isolation and observation for 14 days is necessary for any relevant contacts of a person with SARS-CoV-2 infectious pneumonia.

“Avoiding airborne droplets from infected patients that are being ventilated is important to avoid transmission of these infections,” Surgical Infections Editor-in-Chief Donald E. Fry, M.D., said in a statement.

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