Abstract:
BACKGROUND:Current guidelines for perioperative management of coronavirus disease 19 (COVID-19) are mainly based on extrapolated evidence or expert opinion. We aimed to systematically investigate how COVID-19 affects perioperative management and clinical outcomes, to develop evidence-based guidelines. METHODS:First, we conducted a rapid literature review in EMBASE, MEDLINE, PubMed, Scopus, and Web of Science (January 1 to July 1, 2020), using a predefined protocol. Second, we performed a retrospective cohort analysis of 166 women undergoing Caesarean section at Tongji Hospital, Wuhan during the COVID-19 pandemic. Demographic, imaging, laboratory, and clinical data were obtained from electronic medical records. RESULTS:The review identified 26 studies, mainly case reports/series. One large cohort reported greater mortality in elective surgery patients diagnosed after, rather than before surgery. Higher 30 day mortality was associated with emergency surgery, major surgery, poorer preoperative condition and surgery for malignancy. Regional anaesthesia was favoured in most studies and personal protective equipment (PPE) was generally used by healthcare workers (HCWs), but its use was poorly described for patients. In the retrospective cohort study, duration of surgery, oxygen therapy and hospital stay were longer in suspected or confirmed patients than negative patients, but there were no differences in neonatal outcomes. None of the 262 participating HCWs was infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) when using level 3 PPE perioperatively. CONCLUSIONS:When COVID-19 is suspected, testing should be considered before non-urgent surgery. Until further evidence is available, HCWs should use level 3 PPE perioperatively for suspected or confirmed patients, but research is needed on its timing and specifications. Further research must examine longer-term outcomes. CLINICAL TRIAL REGISTRATION:CRD42020182891 (PROSPERO).
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Zheng H,Hébert HL,Chatziperi A,Meng W,Smith BH,Yan J,Zhou Z,Zhang X,Luo A,Wang L,Zhu W,Hu J,Colvin LAdoi
10.1016/j.bja.2020.08.049subject
Has Abstractpub_date
2020-12-01 00:00:00pages
895-911issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(20)30731-5journal_volume
125pub_type
杂志文章,评审abstract::Intra-oral masses in neonates can seriously compromise the airway, potentially causing hypoxia and death if not recognized and managed appropriately. We report a case in which an intra-oral mass was diagnosed on antenatal ultrasound scan. Preparation for delivery involved a multidisciplinary team approach, with a stra...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.6.951
更新日期:1999-12-01 00:00:00
abstract:Background.:Compromised tissue oxygenation is one of the root causes of dysfunction of various organs and postoperative complications. Oxygenation of different tissue beds may follow different patterns of change during physiological derangement. Methods.:Patients undergoing elective major posterior spine surgery parti...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aex008
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:LMA CTrach (CT), a modified version of the intubating LMA Fastrach, allows continuous video-endoscopy of the tracheal intubation procedure. We tested the hypothesis that the CT is efficient for tracheal intubation of morbidly obese patients who are at risk of a difficult airway. METHODS:After Ethics' Commit...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael219
更新日期:2006-11-01 00:00:00
abstract::The neuromuscular blocking effects of Org 9426, the 2-morpholino, 16-allyl-pyrrolidino derivative of the 3-desacetoxy analogue of vecuronium have been investigated in anaesthetized patients. Based on data from a pilot study, two doses, 250 and 500 micrograms kg-1 (estimated as the ED90 and 2 x ED90, respectively) were...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/64.4.521
更新日期:1990-04-01 00:00:00
abstract::Skills related to driving, the ability to discriminate the fusion of flickering light, and hand and foot proprioception, were measured double-blind in 34 healthy volunteers before and after three doses of i.v. diazepam. The effects of diazepam were most harmful to co-ordination. With 0.15 mg/kg, 0.30 mg/kg and 0.45 mg...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/47.4.457
更新日期:1975-04-01 00:00:00
abstract::In our daily anaesthetic practice, we are confronted with an increasing number of patients treated with either antiplatelet or anticoagulant agents. During the last decade, changes have occurred that make the handling of antithrombotic medication a challenging part of anaesthetic perioperative management. In this revi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew214
更新日期:2016-09-01 00:00:00
abstract::We studied 20 patients undergoing thoracotomy, in a double-blind, placebo-controlled crossover trial of intercostal bupivacaine. Bupivacaine 0.25% was infused at 5 ml h-1 through each of two catheters placed in the intercostal space at operation. Mean (95% confidence limits) 24-h requirements for morphine from a patie...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/70.5.508
更新日期:1993-05-01 00:00:00
abstract::The minimum local analgesic concentration (MLAC) of bupivacaine in labour is defined as the effective concentration in 50% of subjects (EC50). We have used the technique of double-blinded sequential allocation to quantify the bupivacaine sparing effect of the addition of four different doses of extradural fentanyl in ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/78.5.493
更新日期:1997-05-01 00:00:00
abstract::In rats injected s.c. with formalin, behavioural correlates of the amount and pattern of Fos-like immunoreactivity (Fos-Ll) (molecular responses to pain) were studied to test if early phase treatment with 75% nitrous oxide or 2% halothane, or both, suppressed subsequent spinal sensitization. Rats were allocated to fou...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.1.99
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Intraoperative fluid therapy regimens using oesophageal Doppler monitoring (ODM) to optimize stroke volume (SV) (goal-directed fluid therapy, GDT) have been associated with a reduction in length of stay (LOS) and complication rates after major surgery. We hypothesized that intraoperative GDT would reduce the...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aer273
更新日期:2012-01-01 00:00:00
abstract::We have examined the effects of the highly selective alpha 2-adrenoceptor agonist, dexmedetomidine, on noradrenaline release and cell firing in isolated, superfused slices of rat locus coeruleus. Dexmedetomidine decreased both noradrenaline release and cell firing rate in a concentration-dependent fashion, with an EC5...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/71.3.447
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:The memory effect of dexmedetomidine has not been prospectively evaluated in children. We evaluated the feasibility of measuring memory and sedation responses in children during dexmedetomidine sedation for non-painful radiological imaging studies. Secondarily, we quantified changes in memory in relation to ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew421
更新日期:2017-02-01 00:00:00
abstract::It is known that propofol can have effects on atrioventricular node conduction. We report a case where administration of propofol was associated with termination of supraventricular tachycardia. Although a similar phenomenon has been reported in children, this is the first such case in an adult. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:
更新日期:2002-06-01 00:00:00
abstract::Both the performance of breathing systems and recommendations for the fresh gas flows to be used in patients breathing spontaneously can be expressed in ml kg-1 min-1 or fresh gas: total ventilation ratio (VF:VE). We have examined the relationship between these two descriptions. The data of 106 subjects (awake volunte...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/71.6.796
更新日期:1993-12-01 00:00:00
abstract::Blood concentrations of nitrous oxide were measured in anaesthetists, surgeons and theatre nurses. Comparison of anaesthetists and surgeons working in the same theatre showed that in ENT surgeons concentrations were greater (P < 0.01), while in general surgeons they were smaller (P < 0.003). Blood concentrations of ni...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.11.1143
更新日期:1980-11-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine is an α-2-receptor agonist which might be used as an additive to local anaesthetics for various regional anaesthetic techniques. We therefore designed this prospective, double-blinded, controlled volunteer study to investigate the effects of dexmedetomidine as an adjuvant to ropivacaine on pe...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aes400
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Individual patient information from clinical trials is infrequently available, but can provide insights for clinical trials and practice. METHODS:We analysed individual patient information from five randomized trials (913 patients) of i.v. patient-controlled analgesia (IVPCA) plus epidural placebo, morphine...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1093/bja/aep300
更新日期:2009-12-01 00:00:00
abstract::The effect of alfentanil on sympathetic reflexes evoked by supramaximal electrical stimulation of the radial nerve has been observed in five dogs anaesthetized with alpha-chloralose, paralysed with suxamethonium and artificially ventilated. In five dogs during the infusion of alfentanil at a rate of 20 micrograms kg-1...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/61.4.441
更新日期:1988-10-01 00:00:00
abstract::We investigated whether low-dose erythromycin (200 mg) given as an oral premedicant altered the residual gastric volume and its acidity in fasted patients at induction of anaesthesia in a single-blinded study. Sixty patients were allocated randomly to receive either an erythromycin tablet (200 mg) or nothing with 10 m...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/85.6.861
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine (DEX) has been shown to provide good perioperative haemodynamic stability with decreased intraoperative opioid requirements. It may have neural protective effects, and thus may be a suitable anaesthetic adjuvant to neurosurgical anaesthesia. METHODS:Fifty-four patients scheduled for elective...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael220
更新日期:2006-11-01 00:00:00
abstract::We have conducted a randomized, double-blind comparison of 4% and 8% sevoflurane for induction of anaesthesia in unpremedicated patients aged more than 60 yr. Sevoflurane was inhaled in 50% nitrous oxide using a vital capacity breath technique, and mean, systolic and diastolic arterial pressures and heart rate were mo...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/82.1.20
更新日期:1999-01-01 00:00:00
abstract::An oxygen consuming lung model was used for evaluation and validation of a technique for metabolic gas exchange measurements during controlled ventilation. The technique comprised a Servo 900 C ventilator (Siemens) and separate oxygen and carbon dioxide analysers (Beckman). Measurements of oxygen consumption and carbo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.3.311
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Guidelines recommend discontinuation of clopidogrel for 7 days before a neuraxial injection, while other directives suggest that 5 days might be adequate. We examined the time course of antiplatelet activity after clopidogrel discontinuation in patients undergoing epidural injections. METHODS:Thirteen patie...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer298
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:None of the currently available hypnosis monitoring systems have evaluated balanced xenon anaesthesia. We investigated the performance of the bispectral index (BIS) and the composite A-line autoregressive index (cAAI) while comparing balanced xenon with sevoflurane anaesthesia. METHODS:Sixty patients underg...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeq163
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Supraglottic airways (SGAs) have an established role in airway management of difficult airways in both adults and children. However, there are limited data regarding the use of SGAs for primary airway management in children. The aim of this study is to assess the success rates and adverse events related to t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet411
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Clonidine is a useful analgesic-sedative agent; however, few data exist regarding its use in infants after congenital heart disease surgery. We thus aimed to assess the absorption and safety of enterally administered clonidine in this setting. METHODS:Sixteen infants (median age 6.7 months) received a singl...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeu258
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:The aim of this study was to explore difficulties at work from anaesthetists' own perspective and to examine how anaesthetists handle and cope with situations that are perceived as difficult and potentially stressful. METHODS:Two sets of interviews were conducted with 19 specialist anaesthetists in Sweden. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aem233
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:There are no studies comparing local anaesthetic requirements for obese and normal parturients. Obesity has been associated with a higher incidence of Caesarean section and higher levels of epidural block have also been found in obese obstetric patients, suggesting they may require less local anaesthetic. Th...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei284
更新日期:2006-01-01 00:00:00
abstract::In inflammation, leucocytes containing opioid peptides migrate into the tissue. Opioid peptides can be released and bind to opioid receptors on peripheral nerve terminals, which counteracts inflammatory pain. Migration of opioid peptide-containing leucocytes is controlled by chemokines and adhesion molecules. Neurokin...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aen078
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Propofol is used during living-related donor liver transplantation because its metabolism is not greatly affected by liver failure. However, the pharmacokinetics of propofol during liver transplantation have not been fully defined. The purpose of this study was to evaluate the apparent systemic clearance of ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei243
更新日期:2005-11-01 00:00:00