The High-Stakes Balance: Patient Safety and Neurosurgical Practice in a COVID-19 Pandemic
Abstract
Introduction: The COVID-19 pandemic profoundly affected neurosurgical practices globally, prompting the introduction of emergency health protocols to safeguard patients and healthcare personnel. While these measures were essential for controlling virus spread, they were resulted in challenges like surgical delays, resource shortages, and heightened stress for medical staff. This study aims to evaluate the impact of these protocols on neurosurgical care, identify the challenges posed, and suggest strategies to enhance patient safety and healthcare resilience in future outbreaks
Subject and Methods: This qualitative study involved a systematic literature review on PubMed, Google Scholar, and ScienceDirect, along with interviews with neurosurgeons, anesthesiologists, and intensive care specialists. Through thematic analysis, it explored the disruptions in neurosurgical care during the pandemic, the adaptive strategies employed, and their impact on patient outcomes and medical staff well-being.
Results: The study found that while emergency health protocols helped minimize COVID-19 transmission, they caused significant disruptions in neurosurgical care, with 30% of patients experiencing delays that adversely affected their outcomes. PPE shortages, inconsistent preoperative screening, and changing health protocols complicated surgical workflows. Hospitals with structured triage systems, expanded telemedicine, and enhanced preoperative screening managed the crisis better. Additionally, healthcare workers' psychological distress was reduced through improved mental health support and resource availability.
Conclusion: The COVID-19 pandemic has transformed neurosurgical practice, highlighting the need for adaptation and resilience in healthcare. Strengthening collaboration, optimizing resources, and integrating technology will better prepare neurosurgical teams for future public health emergencies while maintaining high-quality patient care.
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Kementerian Kesehatan Republik Indonesia. Situasi terkini perkembangan novel coronavirus (COVID-19) [Internet]. 2020 [cited 2020 Nov 21]. Available from: https://covid19.kemkes.go.id/situasi-infeksi-emerging/info-corona-virus/situasiterkini-perkembangan-coronavirus-covid-19-21-november-2020
Bajunaid K, Alqurashi A, Alatar A, Alkutbi M, Alghamdi J, Alturki A, Alsaif R, et al. Neurosurgical procedures and safety during the COVID-19 outbreak: a case-control multicenter study. World Neurosurg. 2020;143:e179–e187. Doi: 10.1016/j.wneu.2020.07.093
Livingston E, Desai A, Berkwits M. Sourcing personal protective equipment during the COVID-19 outbreak. JAMA. 2020; 323(19):1912-914. Doi: 10.1001/jama.2020.5317
Nugroho SW, Pradhana I, Gunawan K. New adaptation of neurosurgical practice and residency programs during the COVID-19 outbreak and their effects on neurosurgery resident satisfaction and welfare at the National General Hospital, Jakarta, Indonesia. Heliyon. 2021;7(8): 1-6. Doi: 10.1016/j.heliyon.2021.e07757
Giwangkancana G, Anzhari RA, Indriasari. Perioperative care and operating room management. In: Perioperative Care and Operating Room Management. ScienceDirect; 2022;28:100271. https://doi.org/10.1016/j.pcorm.2022.100271.
Iorio-Morin C, Hodaie M, Sarica C, Dea N, Westwick HJ, Christie SD, et al. Letter: The risk of COVID-19 infection during neurosurgical procedures: A review of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) modes of transmission and proposed neurosurgery-specific measures for mitigation. Neurosurgery. 2020;87(2):178-85. Doi: 10.1093/neuros/nyaa157
Zhou L, Zhang M, Wang J, Gao J. SARS-CoV-2: Underestimated damage to nervous system. Travel Med Infect Dis. 2020; 36:1-2. Doi: 10.1016/j.tmaid.2020.101642
Ti LK, Ang LS, Foong TW, Ng BSW. What we do when a COVID-19 patient needs an operation: Operating room preparation and guidance. Can J Anaesth. 2020; 67(6):756-58. Doi: 10.1007/s12630-020-01617-4
Chibbaro S, Ganau M. Todeschi J, Proust F, Cebula H. How SARS-CoV-2 is forcing us to reconsider and reorganize our daily neurosurgical practice. Neurochirurgie 2020; 66:189-191. Doi: 10.1016/j.neuchi.2020.05.001
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: 10.1213/ANE.0000000000004829
Humanitarian Health Action. World Health Organization. Available at: [WHO](https://www.who.int/hac/about/definitions/en/).
Pierce JT, Kositratna G, Attiah MA, Kallan MJ, Koenigsberg R, Syre P, et al. Efficiency of spinal anesthesia versus general anesthesia for lumbar spinal surgery: A retrospective analysis of 544 patients. Loc Reg Anesth. 2017; 10:91-8. Doi: 10.2147/LRA.S141233
Harky A, Chan JSK, Kot TKM, Sanli D, Rahimli R, Belamaric Z, et al. General anesthesia versus local anesthesia in carotid endarterectomy: A systematic review and meta-analysis. Journal of Cardiothorac Vasc Anesth. 2020; 34(1):219-34. Doi: 10.1053/j.jvca.2019.03.029
Surve RM, Bansal S, Reddy M, Philip M. Use of dexmedetomidine along with local infiltration versus general anesthesia for burr hole and evacuation of chronic subdural hematoma (CSDH). J Neurosurg Anesthesiol. 2017; 29(3):274-80. Doi: 10.1097/ANA.0000000000000305
Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 virus targeting the CNS: Tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chem Neurosci. 2020;11(7): 994-98. Doi: 10.1021/acschemneuro.0c00122
Dannhoff G, Mallereau CH, Ganau M, Carangelo BR, Spatola G, Todeschi J, et al. Effects of the COVID-19 outbreak on everyday neurosurgical practice in Alsace, France: lessons learned, current perspectives, and future challenges—preliminary results of a longitudinal multicentric study registry. Medicina 2024; 60 (390): 1-20. Doi: 10.3390/medicina60030390
Hwang CS. Olfactory neuropathy in acute respiratory syndrome: Report of a case. Acta Neurol Taiwanica. 2006; 15(1): 26–8.
Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: A systematic review. PLoS OnE. 2012; 7(4): e35797. Doi: 10.1371/journal.pone.0035797
Peng PWH, Ho PL, Hota SS. Outbreak of a new coronavirus: What anaesthetists should know. Br J Anaesth. 2020; 124(5):497-501. Doi: 10.1016/j.bja.2020.02.008
Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anaesth. 2020; 67(5):568-76. Doi: 10.1007/s12630-020-01591-x
DOI: https://doi.org/10.24244/jni.v14i2.616
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