Procedural sedation in the COVID-19 era

Area of Science:

• Anesthesiology
• Infectious Disease Control
• Healthcare Management

Background:

• The COVID-19 pandemic necessitated a halt in elective procedures, including those requiring procedural sedation.
• Resuming these services demands stringent safety protocols to protect both patients and healthcare professionals from viral transmission.

Purpose of the Study:

• To provide guidelines for the safe resumption of procedural sedation services during the COVID-19 pandemic.
• To outline modifications in sedation practices to mitigate droplet and aerosol transmission risks.

Main Methods:

• Discussion of key considerations: timing of procedures, patient screening and testing protocols.
• Emphasis on appropriate use of personal protective equipment (PPE) and meticulous case planning.
• Exploration of sedative and opioid-sparing strategies, including multimodal analgesia and non-pharmacologic interventions.

Main Results:

• Modified procedural sedation approaches can reduce the risk of droplet or aerosol transmission.
• Decreasing nasal cannula oxygen supplementation flows is a key modification.
• Opioid and sedative sparing strategies, alongside multimodal and non-pharmacologic approaches, reduce the need for oxygen supplementation.

Conclusions:

• Implementing specific guidelines is crucial for safely resuming procedural sedation.
• Adapting sedation techniques and utilizing opioid-sparing methods are vital for minimizing transmission risks.
• Recommendations are provided for managing COVID-19 positive patients requiring procedural sedation.