Journal of anesthesia
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Journal of anesthesia · Jun 2021
Anesthesiologist behavior and anesthesia machine use in the operating room during the COVID-19 pandemic: awareness and changes to cope with the risk of infection transmission.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease [coronavirus disease 2019 (COVID-19) infection] first appeared in December 2019 in China and is now spreading worldwide. Because SARS-CoV-2 can be transmitted via aerosols and surface contaminations of the environment, appropriate use of anesthesia machines and appropriate behavior in the operation room (OR) are required specifically in relation to this disease. The use of high-performance hydrophobic filters with a high rate of virus rejection is recommended as the type of viral filter, and surgical team behaviors that result in aerosol splashes should be avoided. ⋯ Ensuring social distancing-even with a mask in the OR-may be beneficial because healthcare providers may be asymptomatic carriers. After the acute crisis period of COVID-19, the number of cases of essential but nonurgent surgeries for waiting patients is likely to increase; therefore, optimization of OR scheduling will be an important topic. Anesthesiologists will benefit from new standard practices focusing on the prevention of COVID-19 infection.
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Journal of anesthesia · Jun 2021
ReviewAerosol containment device for airway management of patients with COVID-19: a narrative review.
Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), is highly contagious. To protect healthcare workers from infection during airway management, some expert recommendations and guidelines recommended wearing P2/N95 masks, goggles or glasses, glove, face-shields, and gowns as standard personal protective equipment (PPE). Nevertheless, several simulation studies have suggested that the standard PPE may not fully protect healthcare workers. ⋯ Several simulation studies have indicated that "aerosol containment device" would make tracheal intubation more difficult. In addition, the device would prevent the spread of droplets from a patient, but may increase the risk of healthcare workers being exposed to a higher concentration of viral aerosols. Therefore, the current state of knowledge indicates that an "aerosol containment device" without vacuum mechanism has only limited efficacy in protecting healthcare workers from viral transmission.
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Journal of anesthesia · Jun 2021
Preparing for the SARS-CoV-2 pandemic: creation and implementation of new recommendations.
During the SARS-CoV-2 pandemic in 2020, departments of anesthesiology worldwide have encountered new and unique challenges. In this short communication, we present and assess our recommendations for orotracheal intubation, a frequent high-risk procedure. ⋯ Moreover, to reliably implement our newly created measures, we distributed incisive posters and organized comprehensive training sessions. Eventually, we summarize and analyze the occurring problems of our suggestions for intubation during their realization.
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Recently published case reports relating to anesthesia in patients with coronavirus disease (COVID-19) were reviewed. The diagnosis of COVID-19 was confirmed by positive results of reverse transcriptase polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Numerous reports handled emergency cesarean delivery. ⋯ Emergency cerebral shunt reconstruction was performed repeatedly in an eight-month-old boy with COVID-19. The tracheal tube was removed in the operating room after surgery and postoperative course was uneventful. All the procedures should be performed in isolated operating rooms with medical staff with level-3 personal protection to ensure the safety of patients and health care providers.
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Journal of anesthesia · Jun 2021
Randomized Controlled TrialErector spinae block for postoperative pain management in lumbar disc hernia repair.
Lumbar disc herniation is the most common spinal disorder and various less invasive techniques such as microdiscectomy have been described. However, postoperative pain management in patients undergoing discectomy is still commonly inadequate. Erector spinae plane (ESP) block is a relatively easier technique with lower risks of complications, and can be performed to provide postoperative analgesia for various procedures. The current study aimed to determine the effect of ESP block on postoperative analgesia in patients who underwent elective lumbar disc herniation repair surgeries. ⋯ NCT03744689.