Pertimbangan Anestesi Perioperatif untuk Pasien Bedah Saraf dengan Covid-19

Dewi Yulianti Bisri, Tatang Bisri

Abstract


Coronavirus yang baru, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pertamakali timbul di Wuhan, Provinsi Hubei Cina, pada bulan Desember 2019, dan menyebar dengan cepat ke seluruh dunia ke lebih dari 190 negara. Pasien harus ditapis untuk covid-19 menggunakan kombinasi riwayat penyakit, computed tomography (CT) dada, dan pemeriksaan real time quantitative polymerase chain reaction (RT-qPCR) bergantung kebijakan institusinya. Keluhan neurologis seperti dizziness, headache, hypogeusia dan hyposmia, sering (36%) pada pasien covid-19. Encefalopati dan perubahan status mental juga terjadi pada pasien yang telah terinfeksi dengan virus SARS-CoV-2. Penyakit serebrovaskuler lebih sering pada covid-19 yang berat; acute ischemic stroke telah dilaporkan pada 5,7% dan gangguan kesadaran pada 15% pasien. Tindakan pembedahan rutin kranial dan spinal aman untuk dilakukan. Operasi endoscopic endonasal tidak aman dan harus dihindari. Ekstubasi setelah anestesi umum bila memungkinkan dilakukan di ruangan tekanan negatif, personil tetap memakai alat pelindung diri (APD) level 3. Harus dihindari pasien batuk saat ekstubasi. Setelah ekstubasi, pasang oksigen binasal, dan pasien harus memakai masker bedah dan aliran oksigen tinggi harus dihindari (berikan <6L/menit) untuk menghindari terjadinya aerosolisasi

 

Perioperative Anesthesia Consideration for Neurosurgical patients with Covid-19


Abstract

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, Hubei province China, in December 2019, and spread fast to all the world more than 190 countries. Patients should be screened for covid-19 using a combination of history, computed tomography (CT) chest, and real time quantitative polymerase chain reaction (RT-qPCR) testing depending on institutional policies. Neurological symptom as dizziness, headache, hypogeusia and hyposmia, common (36%) at covid-19 patient. Encephalopaty and changed mental status exist in patient infected by SARS-CoV-2 virus. Cerebrovascular diseases more in severe covid-19; acute ischemic stroke had reported in 5.7% and altered level of consciousnes in 15% patient. Surgical measuremet cranial and spinal rutine is safe, endoscopic endonasal surgery not safe and must be avoided. Extubation after general anesthesia if possible do air negative pressure room, and personil still use personal protection equipment (PPE) level 3. Must be avoid patient cough during extubation. After extubation, give oxygen nasal canule, surgical mask, and high flow oxygen (give <6 L/min) avoided given the risk of aerosolization

 


Keywords


Covid-19; neurologik; manifestasi; anestesia; perioperatif; Covid-19; neurological; manifestation; anesthesia; perioperative

Full Text:

PDF

References


Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patient infeted with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395: 497–506.

Burhan E, Susanto AD, Nasution SA, Ginanjar E, Pitoyo CW, Susilo A, dkk. Pedoman tatalaksana Covid-19 Edisi 2, Agustus 2020

World Health Organization. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019.

Flexman AM, Abcejo A, Avitisian R, de Sloovere V, Highton D, Juul N, Li S, et al. Neuroanesthesia practice during the Covid-19 pandemic: Recommendation from Society for Neuroscience in Anesthesiology & Critical Care (SNACC). Journal of Neurosurgical Anesthesiology 2020

Rodriguez-Morales AJ, Cardona-Ospina JA, Gutierrez-Ocampo E, Villamizar-Pena R, Holguin-Rivera Y, Escalera-Antezana JP, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis 2020: Mar 13:101623.

Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation between chest CT findings and clinical conditions of coronavirus disease (COVID-19) pneumonia: a multicenter study. AJR Am J Roentgenol 2020 Mar 3

Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis. Eur Respir J 2020 Mar 26.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395: 1054–62.

Window for detection of SARS-COV-2 infection. ctkbiotech.com

Mao L, Wang M, Chen S, He Q, Chang J, Hong C, et al. Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. medRxiv 2020

Filatov A, Sharma P, Hindi F, Esoinosa PS. Neurological complications of coronavirus disease (COVID-19): encephalopathy. Cureus 2020;12: e7352.

Li Y, Wang M, Zhou Y, Chang J, Xian Y, Wang D, et al. Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study (3/3/2020). Available at SSRN: https://ssrn.com/abstract=3550025 2020.

Zoia C, Bongetta D, Veiceschi P, Cenzato M, Meco FD, Locatelli D, et al. Neurosurgery during the COVID-19 pandemic: update from Lombardy, northern Italy. Acta Neurochir (Wien) 2020 Mar 28.

Baig MA. Neurological manifestation in COVID-19 cause by SARS-CoV. CNS Neurosci Ther. 2020;00:1–3.

Kolikonda MK, Jandrasupali KK, Lippman S. Assosiation of coronavirus disease 2019 and stroke: a rising concern. Neuroepidemiology 2020;54:370-74

Society of British Neurological Surgeon. Transmission of covid-19 during neurosurgical procedures. 20 April 2020

The use of personal protective equipment by anesthesia professionals during the COVID-19 pandemic. American Society of Anesthesiologists 2020. Available at: https://www.asahq.org/about-asa/newsroom/news-releases/2020/03/update-the-use-ofpersonal-protective-equipment-by-anesthesia-professionals-during-the-covid-19-pandemic.

Patel ZM, Fernadex-Miranda J, Hwang PH, Nayak JV, Dodd R, Sajjadi H, et al. Letter: precautions for endoscopic transnasal skull base surgery during the COVID-19 pandemic. Neurosurgery 2020. Available at: https://www.entnet.org/sites/default/files/uploads/covid 19_endosb_lettertoeditor_neurosurgery_update3.23.20.pdf.

Chen X, Liu Y, Gong Y, Guo X, Zuo M, Li J, et al. Perioperative management of patients infected with the novel coronavirus: recommendation from the Joint Task Force of the Chinese Society of Anesthesiology and the Chinese Association of Anesthesiologists. Anesthesiology 2020 Mar 26.

Cook TM, El-Boghdadly K, McGuire B. McNarry AF, Patel A, Higgs A. Consensus guideline for managing the airway in patients with COVID-19. Anesthesia 2020;75:789-99




DOI: https://doi.org/10.24244/jni.v10i1.324

Refbacks

  • There are currently no refbacks.


                                    

 

JNI is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License