How Should Anesthesiologists Face Coronavirus Disease 2019?

Area of Science:

• Anesthesiology
• Infectious Diseases
• Critical Care Medicine

Background:

• Coronavirus disease 2019 (COVID-19) is highly contagious, with severe cases leading to pneumonia and hypoxemia.
• Intubation for severe COVID-19 poses significant infection risks to anesthesiologists due to aerosolization.
• Understanding COVID-19's epidemiology and pathogenesis is crucial for patient management.

Purpose of the Study:

• To outline recommendations for anesthesiologists to prevent infection during COVID-19 patient management.
• To highlight strategies for safe and effective airway management in severely ill COVID-19 patients.
• To review global experiences and research findings on anesthesiology during the COVID-19 pandemic.

Main Methods:

• Review of epidemiological and pathogenetic data of COVID-19.
• Analysis of recommendations for infection control during airway management.
• Discussion of anesthetic techniques, including regional anesthesia and short-acting drugs.
• Exploration of multimodal analgesia and appropriate use of non-steroidal anti-inflammatory drugs.

Main Results:

• Specific protocols for safe intubation, such as maintaining mask seal and using sedatives/analgesics.
• Promotion of spinal cord and regional nerve blocks over general anesthesia.
• Emphasis on short-acting drugs for organ perfusion and avoiding liver/kidney metabolism.
• Advocacy for multimodal analgesia, including NSAIDs when appropriate.

Conclusions:

• Implementing specific infection control measures is vital for anesthesiologists caring for COVID-19 patients.
• Regional anesthesia and judicious drug selection can enhance patient safety and reduce anesthesiologist risk.
• Evidence-based practices and shared experiences are key to optimizing anesthetic management during the COVID-19 pandemic.