Abstract

BackgroundThe high risk of cross-infection during tracheal intubation has caused excessive occupational anxiety for anaesthesiologists amid the novel coronavirus disease 2019 (COVID-19) pandemic. Currently, there is no effective way to attenuate their anxiety in clinical practice. We found that anaesthesiologist with better protective equipment might experience decreased levels of anxiety during intubation.MethodsIn this study, 60 patients who underwent intubation and extubation in the operating room were enrolled, and then randomized 1:1 to either wear protective sleeves (protective sleeve group) or not (control group). Visual analogue scale (VAS) was used to measure the anxiety level of anaesthesiologists during intubation. The respiratory droplets of patients on the sleeve, and the anaesthesiologists’ perception including the patient’s oral malodour, exertion, satisfaction degree, waist discomfort and shoulder discomfort were recorded. The patients’ anxiety, oppressed feelings and hypoxia and postoperative complications were all measured and recorded.ResultsCompared with the control group, the anaesthesiologists in protective sleeve group achieved lower anxiety scores and better satisfaction degrees during the process of intubation and extubation (all P < 0.05). Respiratory droplets were observed only on the inner side, but not the external side, of the protective sleeves (P < 0.001). The incidence of the anaesthesiologists’ perception of patients’ oral malodour was significantly lower in the protective sleeve group (P = 0.02) and no patients developed hypoxemia or intubation-related complications in the protective sleeve group.ConclusionUsing protective devices for intubation might eliminate droplet transmission from patients to anaesthesiologists, while also decreasing their anxiety in a controlled operating room environment.Trial registrationChinese Clinical Trial. no. ChiCTR2000030705. Registry at www.chictr.org.cn on 10/03/2020.

Highlights

  • The high risk of cross-infection during tracheal intubation has caused excessive occupational anxiety for anaesthesiologists amid the novel coronavirus disease 2019 (COVID-19) pandemic

  • The shortage of protective equipment (PPE) has caused thousands of healthcare workers to be infected amid COVID-19 pandemic and exacerbated occupational anxiety [6]

  • Female and male patients scheduled to undergo endotracheal intubation and extubation for elective surgery in the operating room during March ­9th to May ­31st 2020, patients with an American Society of Anaesthesiologists class (ASA) I to II, patients with a Mallampati score of I to II, and patients without upper airway abnormalities were included in this study

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Summary

Introduction

The high risk of cross-infection during tracheal intubation has caused excessive occupational anxiety for anaesthesiologists amid the novel coronavirus disease 2019 (COVID-19) pandemic. There is no effective way to attenuate their anxiety in clinical practice. The global outbreak of the novel coronavirus disease 2019 (COVID-19) has placed a contagious threat on thousands of health-care workers, especially in situations of asymptomatic infection [1], and personal protective equipment (PPE) shortages [2]. Excessive occupational anxiety could result from concerns about the risk of cross-infection and the lack of confidence in the safety measures adopted [6, 7]. The shortage of PPE has caused thousands of healthcare workers to be infected amid COVID-19 pandemic and exacerbated occupational anxiety [6]. There is no effective way to attenuate anaesthesiologists’ anxiety in clinical practice

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