Anesthesia management for cesarean section during coronavirus disease 2019 epidemic
Thirty-six puerperas who underwent emergency cesarean section at Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 24, 2020 to February 9, 2020, who all wore medical surgical masks, were retrospectively included in this study Anesthesia management was performed under tertiary medical protection measures A dedicated anesthesia equipment was separately sterilized Narcotic drugs were used for one patient only, and disposable medical supplies were used for anesthetic supplies Contact transmission should be avoided when a neonate required resuscitation, and early isolation and nucleic acid testing were provided for the neonates The rate of suspected cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 11% , and the rate of clinically diagnosed cases was 17% before surgery The rate of clinically diagnosed cases of SARS-CoV-2 was 22%, the rate of confirmed cases was 8%, and the total positive rate of diagnosis was 31% after surgery The rate of neuraxial anesthesia was 86%, the rate of general anesthesia was 14%, the time of spinal puncture was (15±7) min, the time of tracheal intubation under general anesthesia was (2 1±1 3) min, the operation time was (95±36) min, and blood loss was (276±166) ml The Apgar score of newborns was 8 8±0 5 There was 1 neonate whose mother was diagnosed as having coronavirus disease 2019 after operation, an oropharyngeal swab specimen was obtained at 36 h of birth, and the swab was tested positive for SARS-CoV-2 by nucleic acid testing As of February 10, 2020, an anesthesiologist involved in the operation was diagnosed to have infection by SARS-CoV-2 In conclusion, diagnosis of coronavirus disease 2019 during pregnancy is more difficult, it is necessary to perform anesthesia management for cesarean section under tertiary medical protection Although the difficulty in anesthesia operation is increased under tertiary medical protection, anesthesiologists can carry out standardized anesthesia management and guarantee the safety of maternal and infants and anesthesiologists themselves as long as they are rigorously trained and adhere to protective protocols © 2020 Chinese Medical Association
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86
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- Scientific Repository of Open Access of Portugal (RCAAP)
Introdução: A doença Coronavírus 2019 (COVID-19), causadora do Síndrome Respiratório Agudo Severo 2 (SARS-CoV-2), foi reportada pela primeira vez, em Wuhan (China) e declarada como pandemia em março de 2020. Até à data, são limitadas as informações clínicas, abordagem anestésica e prognóstico das grávidas infetadas. O objetivo deste estudo, foi a caraterização da experiência clínica e segurança das técnicas anestésicas na abordagem à grávida infetada e submetida a técnicas anestésicas/analgésicas para trabalho de parto ou cesariana. Métodos: Foi realizado um estudo retrospetivo incluindo todas as parturientes infetadas admitias no Centro Hospitalar Universitário de São João. Dados sobre o contexto demográfico, epidemiológico, resultados dos estudos laboratoriais e imagem radiológica realizados à admissão foram colhidos. Analisou-se os procedimentos anestésicos/analgésicos realizados, bem como dados relacionados com a cirurgia, puérpera e neonato. Resultados: Incluiu-se neste estudo 15 parturientes infetadas com SARS-CoV-2. Sintomas e características clínicas foram semelhantes às reportadas na população adulta não obstétrica. O parto vaginal e anestesia/analgesia do neuroeixo foi realizada na maioria dos casos, em contraste com os estudos previamente publicados. Das parturientes sob analgesia epidural, a maioria permaneceu com Patient Controlled Epidural Analgesia até ao parto. Apenas em um caso foi necessário anestesia geral e intubação traqueal. Todos os recém-nascidos foram negativos para SARS-CoV-2. Não foram reportados complicações ou eventos críticos maternos ou nos recém-nascidos. Conclusão: Neste estudo, as técnicas regionais para anestesia/analgesia para trabalho de parto foram a primeira linha na abordagem anestésica das parturientes infetadas. A segurança e eficácia destes procedimentos foram verificadas sem complicações maternas ou neonatais.
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Following its emergence in December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused what rapidly became a global pandemic. The precise origin and subsequent path of transmission have not yet been established-but like the other novel coronaviruses that it closely resembles, it appears to have evolved naturally in a bat host. The disease caused by SARS-CoV-2 infection, designated as coronavirus disease 2019 (COVID-19), ranges from asymptomatic, to mild self-limited illness, to progressive pneumonia, respiratory compromise, multiorgan failure, and death. In addition, a hyperinflammatory disease state occurs in a subset of patients, and may be seen either during acute infection or following recovery. The search for effective pharmacological management of COVID-19 continues, but several promising candidates have been identified, including the viral nucleoside analog remdesivir. However, despite the existence of literally thousands of clinical trials, the management of COVID-19 remains challenging, and the development of an optimal, evidence-based therapeutic approach is ongoing. The impact of SARS-CoV-2 and COVID-19 on the biobanking world is evolving and profound-in particular, it is likely that many of mysteries surrounding COVID-19 will be solved via the availability of high-quality, large-scale collection, storage, and analysis of patient specimens. The purpose of this review article is therefore to provide a rapid, comprehensive, and relevant overview and primer on SARS-CoV-2 and COVID-19, with attention to the epidemiology, virology, transmission, clinical features, and major therapeutic options currently existent.
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