Resumen
Introducción: la situación actual causada por el COVID-19 demanda la implementación de nuevas técnicas en el manejo anestésico y los riesgos preexistentes en los servicios quirúrgicos. Objetivo: identificar las consideraciones
anestésicas para pacientes con COVID-19 con el fin de sugerir intervenciones en el área quirúrgica. Metodología: revisión integrativa de alcance descriptivo en conjunto con el cumplimiento de los pasos metodológicos de Whittemore-Knafl y los parámetros PRISMA. Se realizó la búsqueda en las bases de datos: PubMed, BVS, Coronavirus Research Database, SCOPUS, Elsevier y SAGE. Se obtuvieron 953 artículos que, junto a un análisis crítico por CASPe, cumplieron los criterios establecidos de inclusión y exclusión. Resultados: se seleccionaron 27
artículos clasificados en: criterios de selección de técnica anestésica; anestesia general y el uso de medicamentos específicos para el manejo anestésico que disminuyan la tos y prevengan la liberación de aerosoles; manejo de la vía aérea encaminada a evitar intubaciones fallidas; anestesia regional y consideraciones de enfermería sobre la preparación de elementos y dispositivos de manera previa al ingreso del paciente al quirófano; identificación y monitorización de pacientes sintomáticos y asintomáticos durante el proceso perioperatorio. Conclusión: con
respecto a la técnica anestésica, es importante priorizar el uso, en cuanto sea posible, de la anestesia regional guiada con ultrasonido. En caso de requerirse la anestesia general, es recomendable mantener las precauciones para prevenir el contagio con el virus. Para enfermería, es destacable el rol en la preparación de un entorno quirúrgico seguro, del conocimiento sobre la técnica anestésica empleada y los cuidados individualizados según las necesidades requeridas.
Referencias
Di Marzo F, Sartelli M, Cennamo R, Toccafondi G, Coccolini F et al.Recommendations for general surgery activities in a pandemic scenario (SARSCoV-2). Br J Surg. 2020; 107(9): 1104-1106. doi:https://doi.org/10.1002/bjs.11652
Dexter F, Elhakim M, Loftus RW, Seering MS, Epstein RH. Strategies for daily operating room management of ambulatory surgery centers following resolution of the acute phase of the COVID-19 pandemic. J Clin Anesth. 2020; 64: 109854. doi: https://doi.org/10.1016/j.jclinane.2020.109854
Fox SE, Akmatbekov A, Harbert JL, Li G, Brown JQ, Vander Heide RS. Pulmonary and cardiac pathology in African American patients with COVID-19: An autopsy series from New Orleans. Lancet Respir Med. 2020; 8(7): 681-686. doi: https://doi.org/10.1016/S2213-2600(20)30243-5
Greenland JR, Michelow MD, Wang L, London MJ. COVID-19 infection: implications for perioperative and critical care physicians. Anesthesiology; 2020. 132, 1346–1361. doi: https://doi.org/10.1097/ALN.0000000000003303
DePhillipo NN, Larson C, O’Neill O, LaPrade R. Guidelines for ambulatory surgery centers for the care of surgically necessary/time-sensitive orthopaedic cases during the COVID-19 Pandemic. J Bone Joint Surg Am. 2020; 102(11): 933-936. doi: https://doi.org/10.2106/JBJS.20.00489
Stannard D. COVID-19: Impact on Perianesthesia Nursing Areas. J Perianesth Nurs. 2020; 35(3): 237–238. doi: https://doi.org/10.1016/j.jopan.2020.03.009
Obara S. Anesthesiologist behavior and anesthesia machine use in the operating room during the COVID-19 pandemic: awareness and changes to cope with the risk of infection transmission. J Anesth. 2020; 35(3): 251-355. doi: https://doi.org/10.1007/s00540-020-02846-z
Greig PR, Dixson T, McCorkell S. A process for daily checks when using anaesthetic machines to ventilate the lungs of COVID- 19 patients: the ‘domino switch’ technique. Anaesthesia. 2020; 75(7); 973. doi: https://doi.org/10.1111/anae.15098
Dexter F, Parra MC, Brown JR, Loftus RW. Perioperative COVID-19 defense: An evidence based approach for optimization of infection control and operating room Management. Anesth Analg. 2020; 131(1): 37–42. doi: https://doi.org/10.1213/ANE.0000000000004829.
Miller TR, Radcliff TA. Economic shocks from the novel COVID-19 pandemic for anesthesiologists and their practices. Anesth Analg. 2020; 131(1): 112–116. doi: https://doi.org/10.1213/ANE.0000000000004882
Al-Samkari H, Karp Leaf RS, Dzik WH, Carlson JCT, Fogerty AE, Waheed A, et al. COVID-19 and coagulation: Bleeding and thrombotic manifestations of SARS-CoV-2 infection. Blood. 2020; 136(4): 489–500. doi: https://doi.org/10.1182/BLOOD.2020006520
Centers for disease control and prevention (CDC). Enfermedad del coronavirus 2019 (COVID-19) [Internet]. 2020 [citado el 10 de diciembre de 2020]. Disponible en: https://espanol.cdc.gov/coronavirus/2019-ncov/index.html
Wong J, Goh QY, Tan Z, Lie SA, Tay YC, Ng SY, et al. Preparing for a COVID-19 pandemic: a review of operating room outbreak response measures in a large tertiary hospital in Singapore. Can J Anesth. 2020; 67(6): 732–745. doi: https://doi.org/10.1007/s12630-020-01620-9
Ti LK, Ang LS, Foong TW, Wei BS. What we do when a COVID-19 patient needs an operation: operating room preparation and guidance. Can J Anesth. 2020. 67, 756-758. doi: https://doi.org/10.1007/s12630-020-01617-4
Xiao K, Zhai J, Feng Y, Zhou N, Zhang X, Zou JJ, et al. Isolation and characterization of 2019-nCoVlike coronavirus from Malayan pangolins. Nature. 2020. 583: (7815) 286-289. doi: https://doi.org/10.1101/2020.02.17.951335
Whittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs. 2005; 52(5): 546–553. doi: https://doi.org/10.1111/j.1365-2648.2005.03621.x
Galvão TF, Pansani, TSA, Harrad D. Principais itens para relatar revisões sistemáticas e meta-análises: A recomendação PRISMA. Epidemiol Serv Saúde. 2015; 24(2): 335–342. doi:https://doi.org/10.5123/S1679-49742015000200017
Manterola C, Asenjo-Lobos C, Otzen T. Jerarquización de la evidencia. Niveles de evidencia y grados de recomendación de uso actual. Rev Chil Infectol. 2014; 31(6): 705–718. doi: https://doi.org/10.4067/S0716-10182014000600011
Végh T, László I, Juhász M, Berhés M, Fábián Á, Koszta G, et al. A COVID–19-fertőzött betegek anesztéziájának és perioperatív ellátásának gyakorlati szempontjai. Orv Hetil. 2020; 161(17): 692–695. doi: https://doi.org/10.1556/650.2020.31809
Tang LY, Wang J. Anesthesia and COVID-19: What we should know and what we should do. Semin Cardiothorac Vasc Anesth. 2020; 24(2): 127–137. doi: https://doi.org/10.1177/1089253220921590
Gong Y, Cao X, Mei W, Wang J, Shen L, Wang S, et al. Anesthesia considerations and infection precautions for trauma and acute care cases during the COVID-19 pandemic: Recommendations from a task force of the Chinese Society of Anesthesiology. Anesth Analg. 2020; 131(2): 326–334. doi: https://doi.org/10.1213/ANE.0000000000004913
Tarraf S, Zeeni C. Anesthesia in the operating room during the COVID-19 pandemic. Middle East J Anesthesiol. 2020; 27(2): 109–125. Recuperado a partir de: https://pesquisa.bvsalud.org/globalliterature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-832037
Sharma D, Rasmussen M, Han R, Whalin M, Davis M, Kofke WA, et al. Anesthetic management of endovascular treatment of acute ischemic stroke during COVID-19 pandemic: Consensus statement from Society for Neuroscience in Anesthesiology & Critical Care (SNACC). J Neurosurg Anesth. 2020; 32(3): 193–201. doi: https://doi.org/10.1097/ANA.0000000000000688
Romanzi A, Galletti M, Macchi L, Putortì A, Rossi F, Scolaro R, et al. Awake laparotomy: Is locoregional anesthesia a functional option for major abdominal surgeries in the COVID-19 era? Eur Rev Med Pharmacol Sci. 2020; 24(9): 5162–5166. doi: https://doi.org/10.26355/eurrev_202005_21211
Wang E, Mei W, Shang Y, Zhang C, Yang L, Ma Y, et al. Chinese Association of Anesthesiologists Expert Consensus on the use of perioperative ultrasound in coronavirus disease 2019 patients. J Cardiothorac Vasc Anesth. 2020; 34(7): 1727–1732. doi: https://doi.org/10.1053/j.jvca.2020.04.002
Herman JA, Urits I, Kaye AD, Urman RD, Viswanath O. COVID-19: Recommendations for regional anesthesia. J Clin Anesth. 2020; 65: 109885. doi: https://doi.org/10.1016/j.jclinane.2020.109885
Singleton MN, Soffin EM. Daring discourse: Are we ready to recommend neuraxial anesthesia and peripheral nerve blocks during the COVID-19 pandemic? A pro-con. Reg Anesth Pain Med. 2020; 45(10): 831–834. doi: https://doi.org/10.1136/rapm-2020-101653
Kaye K, Paprottka F, Escudero R, Casabona G, Montes J, Fakin R, et al. Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS–COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management. Aesthetic Plast Surg. 2020;44(3):1014–1042. doi: https://doi.org/10.1007/s00266-020-01752-9
Velly L, Gayat E, Quintard H, Weiss E, De Jong A, Cuvillon P, et al. Guidelines: Anaesthesia in the context of COVID-19 pandemic. Anaesth Crit Care Pain Med. 2020; 39(3): 395–415. doi: https://doi.org/10.1016/j.accpm.2020.05.012
Gökce Mİ, Yin S, Sönmez MG, Eryildirim B, Kallidonis P, Petkova K, et al. How does the COVID-19 pandemic affect the preoperative evaluation and anesthesia applied for urinary stones? EULIS eCORE–IAU multicenter collaborative cohort study. Urolithiasis. 2020; 48(4): 345–351. doi: https://doi.org/10.1007/s00240-020-01193-8
Mejía GE, López E. Implicaciones del COVID-19 (SARS-CoV-2) para la práctica anestesiológica. Medwave. 2020; 20(06): e7950. doi: https://doi.org/10.5867/medwave.2020.06.7950
Uppal V, Sondekoppam RV, Landau R, El-Boghdadly K, Narouze S, Kalagara HKP. Neuraxial anaesthesia and peripheral nerve blocks during the COVID-19 pandemic: a literature review and practice recommendations. Anaesthesia. 2020; 75(10): 1350–1363. doi: https://doi.org/10.1111/anae.15105
Fiorelli S, Massullo D, Ibrahim M, Piccioni F, Andreetti C, Vanni C, et al. Perspectives in surgical and anaesthetic management of lung cancer in the era of coronavirus disease 2019 (COVID-19). Eur J Cardio-Thoracic Surg. 2020; 58(4): 676–681. doi: https://doi.org/10.1093/ejcts/ezaa295
Lie SA, Wong SW, Wong LT, Wong TGL, Chong SY. Practical considerations for performing regional anesthesia: lessons learned from the COVID-19 pandemic. Can J Anaesth. 2020; 67(7): 885–892. doi: https://doi.org/10.1007/s12630-020-01637-0
Stewart M, Thaler A, Hunt P, Estephan L, Boon M, Huntley C. Preferential use of total intravenous anesthesia in ambulatory otolaryngology surgery during the COVID-19 pandemic. Am J Otolaryngol. 2020; 41(5): 102570. doi: https://doi.org/10.1016/j.amjoto.2020.102570
Aliste J, Altermatt F, Atton R, Bravo D, Layera S, Miranda P, et al. Recomendaciones para la ejecución de anestesia regional no obstétrica en perioperatorio de pacientes COVID-19. Rev Chil Anest. 2020; 49(3). doi: https://doi.org/10.25237/REVCHILANESTV49N03.08
Lima RM, Reis L de A, Thyrso de Lara FS, Dias LC, Matsumoto M, Mizubuti GB, et al. Recommendations for local-regional anesthesia during the COVID-19 pandemic. Brazilian J Anesthesiol. 2020; 70(2): 159–164. doi: https://doi.org/10.1016/j.bjane.2020.06.002
Kim HJ, Ko JS, Kim T-Y. Recommendations for anesthesia in patients suspected of COVID-19 Coronavirus infection. Korean J Anesthesiol. 2020; 73(2): 89–91. doi: https://doi.org/10.4097/kja.20110
Ashokka B, Chakraborty A, Subramania BJ, Karmakar MK, Chan V. Reconfiguring the scope and practice of regional anesthesia in a pandemic: The COVID-19 perspective. Reg Anesth Pain Med. 2020; 45(7): 536–543. doi: https://doi.org/10.1136/rapm-2020-101541
Hotta K. Regional anesthesia in the time of COVID-19: a minireview. J Anesth. 2020; 35. 341–344. doi: https://doi.org/10.1007/s00540-020-02834-3
Chen Q, Lan X, Zhao Z, Hu S, Tan F, Gui P, et al. Role of anesthesia nurses in the treatment and management of patients with COVID-19. J Perianesth Nurs. 2020; 35(5): 453–456. doi: https://doi.org/10.1016/j.jopan.2020.05.007
Solanki SL, Thota RS, Garg R, Pingle AA, Goswami J, Ranganath N, et al. Society of Onco-Anesthesia and perioperative Care (SOAPC) advisory regarding perioperative management of onco-surgeries during COVID-19 pandemic. Indian J Anaesth. 2020; 66(2): 95-99. doi: https://doi.org/10.4103/ija.IJA_447_20
Hassani J, Kanazi G, Mouzayen D. Summary of recommendations on regional anesthesia and interventional pain procedures during the COVID-19 pandemic. Middle East J Anesthesiol. 2020; 27(2): 153–160.
Mendes ÂB, Penedos C, Rodrigues LV, Varandas J, Lages N, Machado H. The role of locoregional anesthesia in the COVID-19 pandemic. Acta Med Port. 2020; 33(7–8): 522–527. doi: https://doi.org/10.20344/amp.13853
Şentürk M, El Tahan MR, Szegedi LL, Marczin N, Karzai W, Shelley B, et al. Thoracic anesthesia of patients with suspected or confirmed 2019 novel coronavirus infection: Preliminary recommendations for airway management by the European Association of Cardiothoracic Anaesthesiology Thoracic Subspecialty Committee. J Cardiothorac Vasc Anesth. 2020; 34(9): 2315–2327. doi: https://doi.org/10.1053/j.jvca.2020.03.059
Neethirajan SGR, Manickam A. Scheduling elective surgeries following COVID-19: Challenges ahead. J Anaesthesiol Clin Pharmacol. 2020; 36(3): 291-296. doi: https://doi.org/10.4103/joacp.JOACP_317_20
Mahlke L, Flohé S, Matthes G, Paffrath T, Wagner F, Wölfl C, et al. Chirurgie in der SARS-CoV-2- Pandemie: Empfehlungen zum operativen Vorgehen. Unfallchirurg. 2020; 123(7): 571-578. doi: https://doi.org/10.1007/s00113-020-00830-6
Meng L, Qiu H, Wan L, Ai Y, Xue Z, Guo Q, et al. Intubation and ventilation amid the COVID-19 outbreak: Wuhan’s experience. Anesthesiology. 2020; 132(6): 1317-1332. doi: https://doi.org/10.1097/ALN.0000000000003296
Warren J, Sundaram K, Anis H, Kamath AF, Mont MA, Higuera CA, et al. Spinal anesthesia is associated with decreased complications after total knee and hip arthroplasty. J Am Acad Orthop Surg. 2020; 28(5): e213-e221. doi: http://dx.doi.org/10.5435/JAAOS-D-19-00156
Cubillos J, Querney J, Rankin A, Moore J, Armstrong K. A multipurpose portable negative air flow isolation chamber for aerosol-generating procedures during the COVID-19 pandemic. Br J Anaesth. 2020; 125(1): e179-e181. doi: https://doi.org/10.1016/j.bja.2020.04.059
Clariot S, Dumain G, Gauci E, Langeron O, Levesque É. Minimising COVID-19 exposure during tracheal intubation by using a transparent plastic box: A randomised prospective simulation study. Anaesth Crit Care Pain Med. 2020; 39(4): 461-463. doi: https://doi.org/10.1016/j.accpm.2020.06.005
Au Yong PS, Chen X. Reducing droplet spread during airway manipulation: lessons from the COVID-19 pandemic in Singapore. Br J Anaesth. 2020; 125(1): e176-e178. doi: https://doi.org/10.1016/j.bja.2020.04.007
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Derechos de autor 2022 Juan Felipe Álvarez-Guevara, Mauricio Medina-Garzón, Jorge Iván Castellanos-López