Anesthesiology Service, Hospital Ángeles México, Mexico City, Mexico.
Medical Research Unit in Reproductive Medicine, Unidad Médica de Alta Especialidad Hospital de Gineco Obstetricia No. 4, "Luis Castelazo Ayala", Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Asian J Anesthesiol. 2021 Sep 1;59(3):83-95. doi: 10.6859/aja.202109_59(3).0002.
During coronavirus disease 2019 (COVID-19) pandemic, efforts have been made to rethink the health system and provide various recommendations to the best care of patients and for the protection of health personnel. In patients with suspicion or confirmation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who require surgical intervention and anesthetic management, strategies must be established to minimize aerosol-generating procedures. Regional anesthesia (RA) is not considered an aerosol-generating procedure per se and is currently proposed such as a safe strategy and part of comprehensive perioperative care. However, the preoperative evaluation has undergone changes in the context of the COVID-19 pandemic, so in addition to routine preoperative evaluation, a patient-oriented history, clinical, laboratory, and radiologic evaluation should be performed, and a series of general recommendations should be taken into account before, during, and after the performance of RA procedure. A search of PubMed/MEDLINE, Web of Science, and Google Scholar databases was performed until August 22, 2020, using the words: 〞regional anesthesia or nerve block or peripheral nerve block or spinal anesthesia or epidural anesthesia and SARS-CoV-2 or COVID-19 or MERS or SARS-CoV-1 or influenza.〞 We included in this review all articles, regardless of design, published in the English language. Given the benefits reported with the use of RA techniques, both for the patient and for healthcare personnel, it has recently been suggested that RA should be considered as the first choice. However, it is important to generate more precise and homogeneous management guidelines based on the evidence obtained every day during the care of patients with COVID-19.
在 2019 年冠状病毒病(COVID-19)大流行期间,人们努力重新思考卫生系统,并为患者提供最佳护理和保护卫生人员提出了各种建议。对于需要手术干预和麻醉管理且疑似或确诊严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的患者,必须制定策略以最大程度地减少产生气溶胶的程序。区域麻醉(RA)本身并不被认为是产生气溶胶的程序,目前被提议作为一种安全策略和综合围手术期护理的一部分。但是,在 COVID-19 大流行背景下,术前评估发生了变化,因此除了常规术前评估外,还应进行以患者为导向的病史、临床、实验室和影像学评估,并在进行 RA 程序之前、期间和之后应考虑一系列一般建议。在 2020 年 8 月 22 日之前,我们使用以下词语在 PubMed/MEDLINE、Web of Science 和 Google Scholar 数据库中进行了搜索:“区域麻醉或神经阻滞或周围神经阻滞或脊髓麻醉或硬膜外麻醉和 SARS-CoV-2 或 COVID-19 或 MERS 或 SARS-CoV-1 或流感”。我们将所有文章(无论设计如何)都纳入了本综述,这些文章都以英语发表。鉴于 RA 技术的使用为患者和医疗保健人员带来了益处,最近有人建议RA 应被视为首选。但是,根据在 COVID-19 患者护理过程中每天获得的证据,制定更精确和统一的管理指南非常重要。