Novel coronavirus SARS-CoV-2 and COVID-19. Practice recommendations for obstetric anaesthesia: what we have learned thus far

Abstract

SARS-CoV-2 is a novel coronavirus causing a global pandemic of a severe respiratory illness known as COVID-19. To date, globally, over 30,000 people have died from this emerging disease. As clinicians and healthcare systems around the world are rapidly adapting to manage patients with COVID-19, limited data are emerging from different patient populations to support bestpractice and improve outcomes. In this review, we present a summary of emerging data in the obstetric population and offer obstetric and anaesthetic clinicians around the world a set of evidence-driven, practice-based recommendations for the anaesthetic management of pregnant women with suspected or confirmed COVID-19.

Regional anaesthesia and COVID-19: first choice at last?

“…PPE use in the UK is stratified into contact, droplet, and airborne precautions, and current UK guidance in such elective cases with a low risk of conversion to general anaesthesia remains to wear droplet precaution PPE only. 9,10 Outwith the UK, other classifications of PPE have however been suggested, with one such example being: droplet and contact; airborne, droplet, and contact; high-risk aerosol-generating medical procedures. 11 Much COVID-19 guidance is based on pragmatism as well as science.…”

“…11 Much COVID-19 guidance is based on pragmatism as well as science. 10 For example two air changes in an operating theatre does not completely eliminate aerosols; rather, this merely reduces the viral load by some 86%. Five air exchanges increase this to nearly 100% but, in theory at least, guaranteed 100% elimination is impossible.…”

Covid-19 pandemic impact on colonoscopy service and suggestions for managing recovery

“…Other effective methods to decrease patient anxiety and discomfort during colonoscopy are listening to music [14]; hypnosis; and inhalation of nitrous oxide, which improves the patient experience during the procedure and is rapidly eliminated [14,15], minimizing after effects and inconvenience to patients. Although nitrous oxide has not been considered to generate aerosol, this has not been investigated in research studies [16].…”

Recomendaciones prácticas en la paciente obstétrica con infección por COVID-19

“…En una paciente infectada con COVID-19, el momento de mayor riesgo de exposición de los profesionales al virus es el relacionado con la exposición y contacto directo con gotas provenientes de la vía aérea durante la manipulación de la misma, sobre todo durante la intubación y extubación traqueal 14 .…”