Unique challenges in pediatric anesthesia created by COVID-19

Area of Science:

• Anesthesiology
• Pediatric Critical Care
• Infectious Diseases

Background:

• The COVID-19 pandemic has significantly impacted surgical and anesthetic care globally.
• Hospitals face challenges balancing elective surgery delays against COVID-19 patient surges.
• The perioperative risks for pediatric patients with COVID-19 remain unclear.

Purpose of the Study:

• To review existing literature on pediatric patients undergoing general anesthesia during the COVID-19 pandemic.
• To identify documented outcomes and anesthetic considerations for this patient group.
• To discuss modified anesthetic techniques in the absence of comprehensive data.

Main Methods:

• A comprehensive literature search was performed using MEDLINE.
• Publications focusing on pediatric patients with COVID-19 who received general anesthesia were included.
• Eight publications describing a total of 20 pediatric patients met the inclusion criteria.

Main Results:

• Nine of the 20 pediatric patients had documented preoperative COVID-19 symptoms.
• One perioperative death was reported in the reviewed cases.
• The limited number of cases underscores the need for more extensive research.

Conclusions:

• Further studies with larger patient cohorts are essential to accurately assess perioperative risks in pediatric COVID-19 patients.
• Modified anesthetic techniques may be necessary for providing safe care to these patients.
• Current data is insufficient to establish clear guidelines for anesthetic management.