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10.1016/j.bja.2020.03.007

http://scihub22266oqcxt.onion/10.1016/j.bja.2020.03.007
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suck abstract from ncbi


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pmid32234250      Br+J+Anaesth 2020 ; 124 (6): 670-675
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  • Spinal anaesthesia for patients with coronavirus disease 2019 and possible transmission rates in anaesthetists: retrospective, single-centre, observational cohort study #MMPMID32234250
  • Zhong Q; Liu YY; Luo Q; Zou YF; Jiang HX; Li H; Zhang JJ; Li Z; Yang X; Ma M; Tang LJ; Chen YY; Zheng F; Ke JJ; Zhang ZZ
  • Br J Anaesth 2020[Jun]; 124 (6): 670-675 PMID32234250show ga
  • BACKGROUND: The safety of performing spinal anaesthesia for both patients and anaesthetists alike in the presence of active infection with the novel coronavirus disease 2019 (COVID-19) is unclear. Here, we report the clinical characteristics and outcomes for both patients with COVID-19 and the anaesthetists who provided their spinal anaesthesia. METHODS: Forty-nine patients with radiologically confirmed COVID-19 for Caesarean section or lower-limb surgery undergoing spinal anaesthesia in Zhongnan Hospital, Wuhan, China participated in this retrospective study. Clinical characteristics and perioperative outcomes were recorded. For anaesthesiologists exposed to patients with COVID-19 by providing spinal anaesthesia, the level of personal protective equipment (PPE) used, clinical outcomes (pulmonary CT scans), and confirmed COVID-19 transmission rates (polymerase chain reaction [PCR]) were reviewed. RESULTS: Forty-nine patients with COVID-19 requiring supplementary oxygen before surgery had spinal anaesthesia (ropivacaine 0.75%), chiefly for Caesarean section (45/49 [91%]). Spinal anaesthesia was not associated with cardiorespiratory compromise intraoperatively. No patients subsequently developed severe pneumonia. Of 44 anaesthetists, 37 (84.1%) provided spinal anaesthesia using Level 3 PPE. Coronavirus disease 2019 infection was subsequently confirmed by PCR in 5/44 (11.4%) anaesthetists. One (2.7%) of 37 anaesthetists who wore Level 3 PPE developed PCR-confirmed COVID-19 compared with 4/7 (57.1%) anaesthetists who had Level 1 protection in the operating theatre (relative risk reduction: 95.3% [95% confidence intervals: 63.7-99.4]; P<0.01). CONCLUSIONS: Spinal anaesthesia was delivered safely in patients with active COVID-19 infection, the majority of whom had Caesarean sections. Level 3 PPE appears to reduce the risk of transmission to anaesthetists who are exposed to mildly symptomatic surgical patients.
  • |*Anesthetists[MESH]
  • |Adult[MESH]
  • |Anesthesia, Spinal/*adverse effects/*methods[MESH]
  • |Anesthesiologists[MESH]
  • |Betacoronavirus/*isolation & purification[MESH]
  • |COVID-19[MESH]
  • |China[MESH]
  • |Coronavirus Infections/diagnosis/etiology/*transmission[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Pandemics[MESH]
  • |Personal Protective Equipment[MESH]
  • |Pneumonia, Viral/diagnosis/etiology/*transmission[MESH]
  • |Retrospective Studies[MESH]
  • |Risk[MESH]


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