Sadhasivam Saravanan, Arora Rajnish Kumar, Rekapalli Rajasekhar, Chaturvedi Jitender, Goyal Nishant, Bhargava Pranshu, Mittal Radhey Shyam
Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Asian J Neurosurg. 2021 Feb 23;16(1):24-32. doi: 10.4103/ajns.AJNS_379_20. eCollection 2021 Jan-Mar.
The study objective was to systematically review the impact of the current pandemic on neurosurgical practice and to find out a safe way of practicing neurosurgery amid the highly infectious patients with COVID-19.
A review of the PubMed and EMBASE databases was performed. The literature was systematically searched using keywords such as "COVID-19" and "Neurosurgery."
Among the 425 records, 128 articles were found to be eligible for analysis. These articles described the perspectives of the neurosurgical departments during the pandemic, departmental models, and organizational schemes for triaging emergent and nonemergent neurosurgical cases for the optimal utilization of limited resources, and solutions to continue academic and research activities. Triaging systems help us to optimally utilize the limited resources available. Guidelines have been developed for safe neurosurgical practice and for the continuation of clinical and academic activities during this pandemic by various national and international neurosurgical societies. Key changes in the telemedicine regulatory guidelines would help us to continue to provide neurosurgical care. Videoconferences, online education programs, and webinars could help us to overcome the disadvantages brought upon the neurosurgical education by the social-distancing norms.
In an unprecedented time like this, no single algorithm is going to clear the ethical dilemma faced by us. Individual patient triage is a way for maintaining our ethical practice and at the same time, for efficiently utilizing the limited resources. As the pandemic progresses, new guidelines and protocols will continue to evolve for better neurosurgical practice.
本研究旨在系统回顾当前疫情对神经外科实践的影响，并找出在 COVID-19 高传染性患者中安全开展神经外科手术的方法。
对 PubMed 和 EMBASE 数据库进行了检索。使用“COVID-19”和“神经外科”等关键词对文献进行系统搜索。
在 425 条记录中，发现 128 篇文章符合分析条件。这些文章描述了疫情期间神经外科科室的观点、科室模式以及对紧急和非紧急神经外科病例进行分诊以优化有限资源利用的组织方案，以及继续学术和研究活动的解决方案。分诊系统有助于我们优化利用现有的有限资源。各种国家和国际神经外科学会已制定了在本次疫情期间安全开展神经外科手术以及继续临床和学术活动的指南。远程医疗监管指南的关键变化将有助于我们继续提供神经外科护理。视频会议、在线教育项目和网络研讨会可以帮助我们克服社交距离规范给神经外科教育带来的不利影响。
在这样一个前所未有的时期，没有单一的算法能够解决我们面临的伦理困境。对个体患者进行分诊是维持我们道德实践的一种方式，同时也是有效利用有限资源的方式。随着疫情的发展，新的指南和方案将不断演变，以实现更好的神经外科实践。
