Background and aims: Coronavirus disease 2019 (COVID-19) has posed many challenges for healthcare workers around the world. This study aims to present the most appropriate and evidence-based scientific advice for safe regional anesthesia practice during the COVID-19 pandemic. Methods: To perform regional anesthesia during respiratory disease outbreaks, several databases were investigated, including PubMed, Google Scholar, Up-to-date, and ScienceDirect. Searches were in English during a timeframe spanning from February 15, 2019, until February 15, 2021, and the applied keywords were "COVID-19 anesthesia", "surgery", and "operating room" Results: We have focused on definite areas such as workforce and resource planning, modification of clinical setting, preparation of equipment, supplies, and medications, selection of proper personal protective equipment (PPE), cardiorespiratory monitoring of the patient, and sedation and oxygen therapy. Other fields were assessing safe regional anesthesia techniques and monitoring during anesthesia, post-anesthesia care, and follow-ups. In these recommendations, keeping the patients safe while protecting healthcare providers from potential exposure to infection is of particular interest. Conclusion: The safety of healthcare workers and patients during the anesthesia management of suspected and positive COVID-19 cases is of utmost importance. Although there is limited evidence regarding performing regional anesthesia, these presented suggestions summarize the best accessible data and explain some doubts in this respect.
Background: Esophageal spasm is a common problem after Foreign Body Ingestion (FBI) and causes difficulties for foreign bodies’ removal by endoscopic intervention. Sometimes, medication may help relieve spasms and facilitate the removal of a foreign body. In the current study, we introduce a patient with esophageal spasm due to FBI for whom intravenous nitroglycerin was used to treat the spasm.
Methods: The patient was a 48-year-old man who was admitted to emergency department of Shohadaye Tajrish academic Hospital, Tehran, Iran due to FBI and following sever mid-anterior neck pain, nausea and drooling. His vital signs were normal and during endoscopic procedure, we noticed a sharp object attached to the wall of the upper third of the esophagus, causing severe spasm. After trying for an hour to remove the glass under general anesthesia, we were not able to remove it. Finally, intravenous nitroglycerin was used to relieve the spasm and it was easily removed after 2 minutes.
Conclusion: Due to inconsistencies in the clinical results of nitroglycerin, and as notable lack of studies are investigating the effectiveness of the intravenous method, we aimed to share our successful experience.
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