Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka, Osaka, 545-8586, Japan.
J Anesth. 2021 Jun;35(3):378-383. doi: 10.1007/s00540-021-02896-x. Epub 2021 Jan 27.
On Mar 11, 2020, the World Health Organization declared coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a pandemic. Because COVID-19 has a pre-symptomatic period of up to 2 weeks, SARS-CoV-2 infection has continued to spread. Some individuals with SARS-CoV-2 infection have a severe clinical course, while most individuals have mild or moderate symptoms. Because SARS-CoV-2 is transmitted via droplets and secretions, anesthesiologists have higher risks of infection, especially during airway management. Therefore, general anesthesia requiring airway management can be a challenging procedure for anesthesiologists. During the pandemic, many elective surgeries have been postponed or cancelled in most affected countries. Recently, the number of elective surgeries is gradually recovering from the effect of the COVID-19 pandemic, and hence, safe clinical practice and protocols to prevent SARS-CoV-2 transmission to medical staff should be established. This mini-review focuses on the preoperative assessment and decision with regard to scheduling surgery in elective and emergency cases during the COVID-19 pandemic. A standardized questionnaire and algorithm regarding COVID-19 should be used to assess surgical patients preoperatively as it increases the reproducibility and accuracy of the decision whether to proceed with surgery.
2020 年 3 月 11 日,世界卫生组织宣布由严重急性呼吸系统综合症冠状病毒 2(SARS-CoV-2)引起的冠状病毒病(COVID-19)为大流行。由于 COVID-19 的症状前潜伏期长达 2 周,SARS-CoV-2 感染持续传播。一些 SARS-CoV-2 感染者的临床病程严重,而大多数感染者症状轻微或中度。由于 SARS-CoV-2 通过飞沫和分泌物传播,麻醉师感染的风险更高,尤其是在气道管理期间。因此,需要气道管理的全身麻醉对麻醉师来说是一个具有挑战性的过程。在大流行期间,大多数受影响国家已推迟或取消了许多择期手术。最近,由于 COVID-19 的影响,择期手术的数量逐渐恢复,因此应制定安全的临床实践和预防 SARS-CoV-2 传播给医务人员的方案。本综述重点介绍 COVID-19 大流行期间择期和急诊手术的术前评估和决策。应使用针对 COVID-19 的标准化问卷和算法对手术患者进行术前评估,因为这提高了手术是否进行决策的可重复性和准确性。