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2020 ; 124
(6
): 670-675
Nephropedia Template TP
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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
PMID32234250
show 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.