The effect of the COVID-19 pandemic on anesthesia techniques in tertiary hospital: general anesthesia or regional anesthesia - a retrospective cohort study.

Abstract

We aimed to find out how the pandemic process changed the anesthesia methods applied in Çorum Single Tertiary Region Hospital. In our hospital, we investigated the anesthesia methods used for surgical procedures before and during the pandemic, the number of cases, and the impact of the pandemic on emergency and elective surgeries. This is a retrospective cohort study comparing COVID-19 pandemic's effect on the number of surgical operations and anesthesia techniques. The 22-month surgeries during the pandemic period and the 22-month pre-pandemic surgeries were compared in terms of anesthesia methods, branch-specific, and overall case changes. The data obtained were analyzed comparatively in terms of anesthetic techniques, branch-specific and overall case changes of the patients operated on in the operating room before and during the pandemic. While 65,984 surgical procedures were performed in the pre-pandemic period, only 54,352 were performed during the COVID-19 pandemic. The total number of surgical procedures decreased by 17.63% during the pandemic. While there was a 21.1% decrease in elective surgeries due to the pandemic, there was a 71.43% increase in emergency surgeries during the pandemic period. There was a significant disparity in the distribution of both elective and emergency cases by surgical specialty. It was found that the surgical specialties that received the most cases during the pandemic were General Surgery, Obstetrics-Gynecologic Surgery, Urologic Surgery and Orthopedic Surgery. During the COVID-19 pandemic, regional anesthesia (RA) was used in 16.95% of cases (as the primary technique). The use of RA as the primary anesthetic technique was significantly higher (10.61%) than in the pre-pandemic data. It was observed that specialties such as General Surgery, Obstetrics-Gynecologic Surgery, Urologic Surgery, And Orthopedic Surgery were prominent in the distribution of regional anesthesia. The COVID-19 pandemic was not the first and will not be the last and during this period we saw how important the personnel and material management are. Our study plays an important role in showing the uneven distribution of expected surgical procedures in operating rooms during the pandemic situation. It may provide guidance on the distribution of limited and essential personnel and personal protective equipment (PPE, medications, etc.) during the pandemic period. In this context, regional anesthesia may play an important role in the future because it can provide high-quality perioperative care to patients while minimizing the preference for general anesthesia during surgical procedures, thus minimizing personnel burden and limited resource use.