Perioperative Considerations in Surgical Patients with COVID-19 Infection

Kuang-Yao Li ； Chen-Fuh Lam

《E-Da Medical Journal》 7卷4S期 (2020/12) Pp. 22-28

https://doi.org/10.6966/EDMJ.202012/SP_7(4).0005

摘要

Objectives: This article reviews the perioperative care and anesthetic considerations in patients with suspected or confirmed COVID-19 infections. Methods: Several recently reported large-scale clinical cohort studies and the opinions of experts in perioperative care were reviewed to summarize the most updated clinical recommendations for the perioperative care of COVID-19 patients when surgical intervention is unavoidable. Strategies to protect surgical healthcare workers and to maintain a safe operating environment were also discussed. Results: Cumulative evidence indicates that perioperative mortality and major complication rates were significantly higher in patients with COVID-19. Male sex, age over 70 years, American Society of Anesthesiologists (ASA) physical status ＞Ⅲ, and oncology and emergency surgeries were independent risk factors for major postoperative complications. Personal protective equipment should be applied to all the surgical healthcare providers and a negative-pressure operating room is preferred when operating on patients suspected of being infected. Conclusion: All non-urgent surgical procedures involving patients with COVID-19 should be postponed whenever possible, especially elective general or oncology procedures. In situations where surgical intervention is necessary, every effort should be made to prevent the spread of the virus to other patients and healthcare worker. We recommend a standardized collaborative multidisciplinary approach to the perioperative care of surgical patients with COVID-19.

關鍵字

anesthesia ； COVID-19 pandemic ； negative-pressure operating room ； perioperative risks ； surgical outcomes

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