• Alexa Lynn Grudzinski, Billy Sun, MengQi Zhang, Agnes Crnic, Abdul H Djokhdem, Mary Hanna, Joshua Montroy, Laura V Duggan, Gavin M Hamilton, Dean A Fergusson, Sylvain Boet, Daniel I McIsaac, and Manoj M Lalu.
• Department of Anesthesiology and Pain Medicine, University of Ottawa, The Ottawa Hospital, Room B307, 1053 Carling Ave, Mail Stop 249, Ottawa, ON, K1Y 4E9, Canada.
• Can J Anaesth. 2022 May 1; 69 (5): 644657644-657.

PurposeNumerous guideline recommendations for airway and perioperative management during the COVID-19 pandemic have been published. We identified, synthesized, and compared guidelines intended for anesthesiologists.SourceMember society websites of the World Federation of Societies of Anesthesiologists and the European Society of Anesthesiologists were searched. Recommendations that focused on perioperative airway management of patients with proven or potential COVID-19 were included. Accelerated screening was used; data were extracted by one reviewer and verified by a second. Data were organized into themes based on perioperative phase of care.Principal FindingsThirty unique sets of recommendations were identified. None reported methods for systematically searching or selecting evidence to be included. Four were updated following initial publication. For induction and airway management, most recommended minimizing personnel and having the most experienced anesthesiologist perform tracheal intubation. Significant congruence was observed among recommendations that discussed personal protective equipment. Of those that discussed tracheal intubation methods, most (96%) recommended videolaryngoscopy, while discordance existed regarding use of flexible bronchoscopy. Intraoperatively, 23% suggested specific anesthesia techniques and most (63%) recommended a specific operating room for patients with COVID-19. Postoperatively, a minority discussed extubation procedures (33%), or care in the recovery room (40%). Non-technical considerations were discussed in 27% and psychological support for healthcare providers in 10%.ConclusionRecommendations for perioperative airway management of patients with COVID-19 overlap to a large extent but also show significant differences. Given the paucity of data early in the pandemic, it is not surprising that identified publications largely reflected expert opinion rather than empirical evidence. We suggest future efforts should promote coordinated responses and provide suggestions for studying and establishing best practices in perioperative patients.Study RegistrationOpen Science Framework ( https://osf.io/a2k4u/ ); date created, 26 March 2020.© 2022. Canadian Anesthesiologists' Society.

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