Anesthesia in the operating room during the COVID-19 pandemic

Abstract

The novel coronavirus, SARS-CoV-2, was first isolated in Wuhan, China in December 2019, after clusters pneumonia of unknown etiology surfaced. The infectious disease caused by this virus, known as COVID-19, overwhelmed healthcare systems worldwide; often causing shortages of personal protective equipment (PPE), ventilators, and intensive care unit beds. This pandemic prompted radical healthcare system modifications, affecting all hospital activities and in particular operating room (OR) activities where transmission between patients and healthcare providers happens easily. Multiple policies and protocols on the administrative, engineering and PPE levels need to be implemented to mitigate the effects of the virus. Firm infection control strategies need to be established including proper PPE donning and doffing, organized movement of staff and patients into and out of the operating theatre, and adequate OR ventilation and engineering systems to combat the virus spread. Protocolization of different anesthetic techniques is necessary, aiming at unifying the best available evidence and creating a common ground for anesthesiologists to provide safe care, under the umbrella of effective interdisciplinary communication between the anesthesia, surgical and nursing teams. Finally, a plan for emergency surgeries that takes into consideration the acuity of the condition, and the level of COVID-19 suspicion guides the segregation of patients in order to maintain a smooth, effective and safe OR workflow. © 2020, American University of Beirut. All rights reserved.