Regional anesthesia in the coronavirus disease (COVID-19) pandemic: Clinical guidelines by AORA, India

Ponde, Vrushali; Diwan, Sandeep; Gopal, T V S; Subramanian, Jayakumar; Danish, Mohammed Azam

doi:10.4103/joacp.joacp_277_20

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…Lastly, as many benefits that PRA has always offered, COVID-19 bring us to consider the importance of PRA again. 20 In conclusion, complications in PRA are rare in spite of the fact that blocks in this age group are mostly performed under sedation or general anaesthesia. Systematic training, the right equipment, knowledge of anatomy, understanding of the local anaesthetic drugs, vigilant monitoring, training in USG regional anaesthesia and an attitude of keeping abreast with the latest information goes a long way in improving safety.…”

Section: Discussionmentioning

confidence: 91%

Complications in paediatric regional anaesthesia: a narrative review

Ponde¹,

Uemera²,

Singh³

2020

South Afr J Anaesth Analg

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Paediatric anaesthesia and paediatric regional anaesthesia are intertwined. Currently, almost all paediatric patients posted for surgery could and should be given a regional block unless and until contraindicated. This is because the scope, techniques, and their benefits have a wide range and complications are rare. The first report that used regional anaesthesia in children was in 1898, and over the last 120 years it has been developed with many scholars’ wisdom, ideas and publications. Paediatric regional anaesthesia (PRA) has many advantages but requires experience and expertise. For a long-time, exclusively landmark-guided techniques were used and gradually the development of new techniques such as the use of neuro-stimulator and ultrasound-guided (USG) blocks developed into PRA. Especially, the application of ultrasonography (US) has revolutionised the practice of PRA. Few limitations of regional anaesthesia can be tackled by the use of US, leading to shorter time to perform the block, reduced time for block onset and use of a smaller volume of local anaesthetic. Life threatening complications of regional anaesthesia are rare and the riskbenefit ratio is favourable. However, a thorough insight into RA complications, no matter how rare they are, is essential for safe practice. This is because they can be life-threatening, and no matter how small the percentage is, when complications occur, for that individual patient statistics is irrelevant.

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Section: Discussionmentioning

confidence: 91%

Complications in paediatric regional anaesthesia: a narrative review

Ponde¹,

Uemera²,

Singh³

2020

South Afr J Anaesth Analg

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“…In COVID-19 infected/suspected patients during the pandemic, the role of RA has been emphasized over GA whenever possible [3]. Several guidelines for RA practice in the COVID-19 pandemic are available from various societies like the Indian Society of Anesthesiologists (ISA) [8], Association of Regional Anesthesia (AORA) [9] and American Society of Regional Anesthesia-European Society of Regional Anesthesia (ASRA-ESRA) [4] guidelines reiterate the same. This is supported in our survey where we found the majority of the respondents preferred RA over GA during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

A Cross-Sectional Study to Ascertain the Effect of COVID-19 Pandemic on Regional Anaesthesia Practices Amongst Anaesthesiologists of India

Gupta¹,

Krishna²,

Narayanan³

et al. 2022

Cureus

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Background and aimsRegional anaesthesia has been advocated as a preferred modality during the coronavirus disease 2019 (COVID-19) pandemic, but pursuing regional anaesthesia during COVID-19 is challenging. Our crosssectional survey aimed to analyze the challenges in conducting regional anaesthesia and the alterations in practices imposed by the COVID-19 pandemic across the nation. Material and methodsThe questionnaire was validated by seven experts. Following ethical approval and trial registration, this Google Forms-based survey was circulated to anaesthesiologists across the country via emails over 3 months (April 2021 to June 2021). Weekly reminders were sent to the non-responders till the desired sample size was attained, after which the survey was closed and responses were analyzed. ResultsFive hundred and thirty-two of 1100 anaesthesiologists completed the survey (48.3% response rate). Among the 532 respondents, 65.8% reported an increase in the use of regional anaesthesia due to the pandemic, with 77.4% reporting a change in practice. Almost 90% of the respondents used a dedicated operation theatre for all infected patients. Most respondents (75%) used disposable plastic drapes (75%) and full personal protective equipment (PPE) for COVID-19-positive patients during the procedure. However, using PPE resulted in poor vision due to fogging and multiple attempts and increased performance duration. Most respondents (74.4%) used gloves to maintain ultrasound probe sterility, while many other respondents (65.7%) used a sterile camera cover for the same. Many respondents ordered inflammatory markers during preoperative evaluation. ConclusionThe present survey revealed that there was increased utilization of regional anaesthesia with increased utilization of PPE, sterility routines, and ordering of investigations. The use of PPE led to many challenges while performing regional anaesthesia. However, many deviations were identified from the accepted recommendations, and one needs to be aware of proper practices to achieve optimal patient outcomes and provider safety.

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“…Ainda, pode reduzir a morbidade perioperatória e fornecer analgesia prolongada (frequentemente 24 horas) sem sedação, diminuindo a administração e efeitos adversos das terapias farmacológicas para o manejo da dor pósoperatória, hemodinâmica estável, necessidade reduzida de outros anestésicos e oxigênio e rápida recuperação. Benefícios adicionais incluem redução de náuseas e vômitos e redução de disfunção cognitiva e alucinações (Ashokka et al, 2020;Cesur et al, 2020;Gangakhedkar & Chincholi, 2020;Herman et al, 2020;Moll et al, 2021;Moreira et al, 2020;Ponde et al, 2020;Uppal et al, 2020).…”

Section: Anestesia Geral E Regional No Contexto Da Pandemia Da Covid-19unclassified

Anestesia regional como alternativa para procedimentos médicos na pandemia da COVID-19

Segundo

Pavanello

Paiva

2021

RSD

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A pandemia de coronavírus (SARS-CoV-2) impactou significativamente os sistemas de saúde e desafiou a equipe multidisciplinar, sendo considerado um problema de saúde pública global. Diversas estratégias foram sugeridas visando a segurança e minimizar a exposição dos profissionais de saúde e pacientes hospitalizados ao vírus, sendo uma destas evitar procedimentos geradores de aerossóis durante os procedimentos cirúrgicos, como o manejo das vias aéreas. Diante disto, a anestesias regional e local tornaram-se como uma alternativa viável, eficaz e segura a anestesia geral, desempenhando um papel importante durante o surto da COVID-19, quando aplicável. Dentre as vantagens pode-se citar a não geração de aerossóis, analgesia pós-operatória, redução de náuseas e vômitos e também, de complicações cardiorrespiratórias. Este estudo objetiva investigar a aplicação da anestesia regional nas diversas especialidades médicas durante a pandemia de coronavírus avaliando os resultados do emprego desta. Foi realizada uma busca nas bases de dados Pubmed, Web of Science (todas as bases de dados), Scopus, Embase e Cochrane Library utilizando os termos de busca “SARS-CoV-2”, “COVID-19”, “Anesthesia, Local” e “Anesthetics, Local” onde 49 referências foram incluídas. Os estudos demonstram bons resultatos nas técnicas empregadas e possibilitam uma alternativa de tratamento em diversos campos cirúrgicos de maneira segura. Dessa forma a anestesias regional e local são adequadas e viáveis para procedimentos médicos cirúrgicos e constituem uma boa alternativa a anestesia geral podendo ser aplicadas em diferentes especialidades cirúrgicas.

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Regional anesthesia in the coronavirus disease (COVID-19) pandemic: Clinical guidelines by AORA, India

Cited by 6 publications

References 19 publications

Complications in paediatric regional anaesthesia: a narrative review

Complications in paediatric regional anaesthesia: a narrative review

A Cross-Sectional Study to Ascertain the Effect of COVID-19 Pandemic on Regional Anaesthesia Practices Amongst Anaesthesiologists of India

Anestesia regional como alternativa para procedimentos médicos na pandemia da COVID-19

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