Anaesthetic management of a COVID-19 parturient for caesarean section - Case report and lessons learnt

Chhabra, Anjolie; Rao, Tangirala Nageswara; Kumar, Mritunjay; Singh, Yogendra; Subramaniam, Rajeshwari

doi:10.4103/ija.ija_509_20

Cited by 15 publications

(5 citation statements)

References 8 publications

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“…Spinal anesthesia was uneventful in our pregnant patient; nevertheless, several published case reports and case series have reported the safe use of spinal, epidural and general anesthesia for the parturient with COVID-19. [ 3 4 11 ] The incidence of hypotension has been reported to be excessive during epidural anesthesia;[ 11 ] but we did not observe hypotension. For severely ill parturients, it has been suggested that general anesthesia with endotracheal intubation should be administered.…”

Section: Discussionmentioning

confidence: 53%

“…Though the instructions were given through telephone, a proper pre-anesthetic checkup was done in the OT itself. Considering previously published case reports,[ 3 4 ] subarachnoid block was planned to decrease the chances of aerosol generation which may occur during general anesthesia and patient was well counseled for subarachnoid block. Just before administration of anesthesia, a sample of CSF was collected in a sterile container and the specimen was sent immediately for examination by RT-PCR method [ Figure 1 ].…”

Section: Clinical Scenariomentioning

confidence: 99%

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Exploring the unknown territories in the new normal world of COVID

Bajwa

Gupta

Wahi

et al. 2020

J Anaesthesiol Clin Pharmacol

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It is now well known that the severe acute respiratory syndrome (SARS-CoV-2) originated in the Wuhan province of Hubei, China in 2019. Having spread across different countries of the world, this highly contagious disease has posed many challenges for the healthcare workers to work without endangering themselves and their patients' wellbeing. Several things are yet not clear about the virus and the presence or absence of the virus in the cerebrospinal fluid (CSF) is currently a debated topic. This article reports the perioperative management of two coronavirus disease-19 positive cases, one of whom was a pregnant patient. Their CSF samples, which were collected during the administration of spinal anesthesia, tested to be negative for viral reverse transcription polymerase chain reaction (RT-PCR) test. We wish to highlight from these cases, that during spinal anesthesia, CSF in mildly symptomatic COVID-19 cases probably does not pose a risk of transmission to the anesthesiologist. However, we suggest that due to the varied presentations of the virus, health care personnel, especially anesthesiologists have to be careful during the perioperative management of such cases.

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Section: Discussionmentioning

confidence: 53%

Section: Clinical Scenariomentioning

confidence: 99%

Exploring the unknown territories in the new normal world of COVID

Bajwa

Gupta

Wahi

et al. 2020

J Anaesthesiol Clin Pharmacol

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“…The patient was given subarachnoid block, reducing the requirement of oxygen with spontaneous breathing and safe delivery of the baby took place. [ 12 ]…”

Section: Oxygen Crisis and Strategies To Beat It!mentioning

confidence: 99%

Anaesthesiology as an oasis amid the crisis of the vital medicine ‘Oxygen’- innovations and local modifications

Mehdiratta¹,

Sharma²,

Jain³

2021

Indian Journal of Anaesthesia

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“…5 In spite of a proliferation of published literature on the COVID-19 disease, data regarding CD and outcomes after anaesthesia in COVID-19 parturients is still scanty; mainly consisting of a few publications from China and a single case report from India. 6 Since COVID-19 parturients may develop COVID-19 related complications, their length of hospital stay can be expected to be longer as shown in a study from China. 7 However, this study included both CD as well as normal delivery and abortions.…”

Section: Introductionmentioning

confidence: 99%

Anaesthetic management in COVID-19 parturients scheduled for caesarean delivery - a comparison with non-COVID-19 parturients

Singh

Neelakandan

et al. 2021

Int J Res Med Sci

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Background: Data regarding outcomes after anaesthesia in COVID-19 parturients is scanty. There is hardly any information about the length of hospital stay in COVID-19 parturients who undergo caesarean delivery (CD) as compared to non-COVID-19 parturients.Methods: An observational study of COVID-19 parturients undergoing CD was conducted. Age and CD indication matched non COVID-19 parturients were taken as controls. The length of hospital stay along with maternal and neonatal outcomes were studied.Results: A total of 45 COVID-19 parturients and an equal number of non-COVID-19 parturients were studied. The length of hospital stay was significantly longer in COVID-19 parturients as compared to non-COVID-19 parturients (4.3±1.6 days versus 3.3±0.6 days, p=0.02). One COVID-19 parturient developed severe disease and expired. Apart from this case, the maternal and neonatal outcomes were comparable between the two groups. Mild thrombocytopenia was seen in COVID-19 parturients. One neonate had a positive reverse transcriptase polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on first day of life.Conclusions: COVID-19 parturients who undergo CD have a longer length of hospital stay than non-COVID-19 parturients. Severe disease is likely to be associated with longer length of hospital stay. Intraoperative hypotension, maternal and neonatal outcome is not significantly different between COVID-19 and non COVID-19 although mild thrombocytopenia is seen in COVID-19 parturients. While vertical transmission of SARS-CoV-2 may be possible, more data is needed regarding vertical transmission is needed.

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Anaesthetic management of a COVID-19 parturient for caesarean section - Case report and lessons learnt

Cited by 15 publications

References 8 publications

Exploring the unknown territories in the new normal world of COVID

Exploring the unknown territories in the new normal world of COVID

Anaesthesiology as an oasis amid the crisis of the vital medicine ‘Oxygen’- innovations and local modifications

Anaesthetic management in COVID-19 parturients scheduled for caesarean delivery - a comparison with non-COVID-19 parturients

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