Regional Anesthesia and Acute Pain ManagementRegional Anesthesia and Acute Pain ManagementРегионарная анестезия и лечение острой боли1993-65082687-1394Eco-Vector4431510.17816/RA44315ReviewsНаучные обзорыReview ArticleRegional anesthesia and COVID-19Регионарная анестезия и COVID-19https://orcid.org/0000-0003-0960-7426SafinRustam R.СафинРустам Рафильевич
Russian Federation

MD, Professor of the Department of Physiology

д.м.н., профессор кафедры физиологии и патологии

safin_r.r@hotmail.comhttps://orcid.org/0000-0002-3400-8989KoriachkinV. A.КорячкинВ. А.
Russian Federation
safin_r.r@hotmail.comhttps://orcid.org/0000-0002-3043-4833GeraskovE. V.ГераськовЕ. В.
Russian Federation
safin_r.r@hotmail.comhttps://orcid.org/0000-0002-6127-0798ZabolotskiiD. V.ЗаболотскийД. В.
Russian Federation
safin_r.r@hotmail.comMari state UniversityФГБОУ ВО «Марийский государственный университет»Saint Petersburg state pediatric medical UniversityФГБОУ ВО «Санкт-Петербургский государственный педиатрический медицинский университет» Министерства здравоохранения Российской ФедерацииFederal center of traumatology, orthopedics and endoprostheticsФГБУ «Федеральный центр травматологии, ортопедии и эндопротезирования» Министерства здравоохранения Российской Федерации170920201416111709202017092020Copyright ©; 2020, Eco-VectorCopyright ©; 2020, ООО "Эко-Вектор"2020Eco-VectorООО "Эко-Вектор"https://rjraap.com/1993-6508/article/view/44315

In the light of the spread of COVID-19, the anesthesiology services has been challenged with an urgent need to ensure safety of the practicing professionals. Suggesting no manipulations on face-to-face contacts, regional anesthesia has proved to be the most appropriate method of anesthesia in the situation of the COVID-19 pandemic. The review outlines indications for recommending regional anesthesia to patients diagnosed with COVID-19 and offers safety rules of its conduction. Any detailed and substantiated treatment plan for the patient category under discussion shall enable not only the recovery of the patient, but also the safety of the medical workers.

В связи с широким распространением среди населения COVID-19, перед анестезиологической службой остро возникла необходимость обеспечения защиты персонала при оказании медицинской помощи. Поскольку регионарная анестезия предполагает отказ от какой-либо манипуляции в зоне дыхательных путей, то именно этот вид обезболивания оказался наиболее приемлемым методом анестезии в условиях пандемии COVID-19. В обзоре приводятся рекомендации относительно выбора регионарной анестезии у пациентов с COVID-19, правила по обеспечению её безопасного проведения. Имея детально разработанный и обоснованный план ведения данного контингента пациентов, необходимо ориентироваться не только на хороший результат лечения, но и на обеспечение безопасности для медицинских работников.

coronavirusCOVID-19neuraxial anesthesiaregional anaesthesiapersonal protective equipmentreviewкоронавирусCOVID-19нейроаксиальная анестезиярегионарная анестезиясредства индивидуальной защитыобзорImai N., Cori A., Dorigatti I. et al. Report 3: Transmissibility of 2019-nCoV. 2020. WHO Collaborating Centre for Infectious Disease Modelling, MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, UK. DOI.org/10.25561/77148.Sanche S., Lin Y.T., Xu C., Romero-Severson E., Hengartner N., Ke R. High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2. Emerg Infect Dis. 2020; 26(7):1470-7. DOI:10.3201/eid2607.200282.Uppal V., Sondekoppam R.V., Landau R., El-Boghdadly K., Narouze S., Kalagara H.K.P. Neuraxial anaesthesia and peripheral nerve blocks during the COVID-19 pandemic: a literature review and practice recommendations [published online ahead of print, 2020 Apr 28]. Anaesthesia. 2020;10.1111/anae.15105. DOI:10.1111/anae.15105.Wyssusek K., Eames G., Peters N., Lee J. Anaesthesia preparedness for COVID-19 pandemic readiness: a medication preservation strategy [published online ahead of print, 2020 May 31]. Br J Anaesth. 2020;S0007-0912(20)30409-8. DOI:10.1016/j.bja.2020.05.027.Infection Prevention and Control of Epidemic- and Pandemic-Prone Acute Respiratory Infections in Health Care. Geneva: World Health Organization; 2014. Available at: https://www.ncbi.nlm.nih.gov/books/NBK214359/.Tran K., Cimon K., Severn M., Pessoa-Silva C.L., 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 P.W.H., Ho P.L., Hota S.S. 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.In Russia, 489 doctors who were infected with coronavirus died. Available at: https://ria.ru/20200618/1573109268.html (access date 29.06.2020).В России умерли 489 медиков, заразившихся коронавирусом. Сайт РИА Новости [Электронный ресурс]. Режим доступа: https://ria.ru/20200618/1573109268.html (дата обращения 29.06.2020).Cook T., Kursumovic E., Lennane S. Exclusive: deaths of NHS staff from Covid-19 analysed. HSJ 22nd April 2020. Available at: https://www.hsj.co.uk/exclusive-deaths-of-nhs-staff-from-covid-19-analysed/7027471.article.Stahel P.F. How to risk-stratify elective surgery during the COVID-19 pandemic? Patient Saf. Surg. 2020;14:8. DOI:10.1186/s13037-020-00235-9.Herman J.A., Urits I., Kaye A.D., Urman R.D., Viswanath O. COVID-19: Recommendations for regional anesthesia [published online ahead of print, 2020 May 20]. J. Clin. Anesth. 2020;65:109885. DOI:10.1016/j.jclinane.2020.109885.Bauer M.E., Bernstein K., Dinges E. et al. Obstetric Anesthesia During the COVID-19 Pandemic. Anesth. Analg. 2020;131(1): 7-15. DOI:10.1213/ANE.0000000000004856.Aliste J., Altermatt F.R., Atton R. et al. Regional anesthesia during the COVID-19 pandemic: a time to reconsider practices? (Letter #2) [published online ahead of print, 2020 May 1]. Can. J. Anaesth. 2020;1-2.DOI:10.1007/s12630-020-01682-9.Wong J., Goh Q.Y., Tan Z. 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. Anaesth. 2020; 67(6):732-45. DOI:10.1007/s12630-020-01620-9.Chee V.W., Khoo M.L., Lee S.F., Lai Y.C., Chin N.M. Infection control measures for operative procedures in severe acute respiratory syndrome-related patients. Anesthesiology. 2004;100 (6):1394-8. DOI:10.1097/00000542-200406000-00010.Hui D.S., Chow B.K., Chu L. et al. Exhaled air dispersion and removal is influenced by isolation room size and ventilation settings during oxygen delivery via nasal cannula. Respirology. 2011;16(6):1005-13. DOI:10.1111/j.1440-1843.2011.01995.x.Cook T.M., El-Boghdadly K., McGuire B., McNarry A.F., Patel A.,Higgs A. Consensus guidelines for managing the airway in patients with COVID-19: Guidelines from the Difficult Airway Society, the Association of Anaesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetists. Anaesthesia. 2020;75(6):785-99. DOI:10.1111/anae.15054.Chan M.T.V., Chow B.K., Lo T. et al. Exhaled air dispersion during bag-mask ventilation and sputum suctioning – Implications for infection control. Sci. Rep. 2018;8(1):198. DOI: 10.1038/s41598-017-18614-1.Lyons C., Callaghan M. The use of high-flow nasal oxygen in COVID-19. Anaesthesia. 2020;75(7):843-7. DOI:10.1111/anae. 15073.Dobson G., Chong M.A, Chow L. et al. Procedural sedation: a position paper of the Canadian Anesthesiologists’ Society. Sédation procédurale : exposé de principe de la Société canadienne des anesthésiologistes. Can. J. Anaesth. 2018;65(12): 1372-84. DOI:10.1007/s12630-018-1230-z.Zhao S., Ling K., Yan H. et al. Anesthetic Management of Patients with COVID 19 Infections during Emergency Procedures. J. Cardiothorac. Vasc. Anesth. 2020;34(5):1125-31. DOI: 10.1053/j.jvca.2020.02.039.Xia H., Zhao S., Wu Z., Luo H., Zhou C., Chen X. Emergency Caesarean delivery in a patient with confirmed COVID-19 under spinal anaesthesia. Br. J. Anaesth. 2020;124(5):e216-e218. DOI:10.1016/j.bja.2020.02.016.Bauer M.E., Toledano R.D., Houle T. et al. Lumbar neuraxial procedures in thrombocytopenic patients across populations: A systematic review and meta-analysis. J. Clin. Anesth. 2020; 61:109666. DOI:10.1016/j.jclinane.2019.109666.Gou S.M., Yin T., Xiong J.X., Peng T., Li Y., Wu H.S. Zhonghua Wai Ke Za Zhi. 2020;58(5):326-30. DOI:10.3760/cma.j.cn 112139-20200224-00123.Zhong Q., Liu Y.Y., Luo Q. et al. Spinal anaesthesia for patients with coronavirus disease 2019 and possible transmission rates in anaesthetists: retrospective, single-centre, observational cohort study. Br. J. Anaesth. 2020;124(6):670-5. DOI:10.1016/j.bja.2020.03.007.El-Boghdadly K., Chin K.J., Chan V.W.S. Phrenic Nerve Palsy and Regional Anesthesia for Shoulder Surgery: Anatomical, Physiologic, and Clinical Considerations. Anesthesiology. 2017; 127(1):173-91. DOI:10.1097/ALN.0000000000001668.Walsh E.E., Shin J.H., Falsey A.R. Clinical impact of human coronaviruses 229E and OC43 infection in diverse adult populations. J. Infect. Dis. 2013;208(10):1634-42. DOI:10.1093/infdis/jit393.El-Boghdadly K., Pawa A., Chin K.J. Local anesthetic systemic toxicity: current perspectives. Local Reg. Anesth. 2018;11:35-44. Published 2018 Aug 8. DOI:10.2147/LRA.S154512.Matava C.T., Yu J., Denning S. Clear plastic drapes may be effective at limiting aerosolization and droplet spray during extubation: implications for COVID-19. Can. J. Anaesth. 2020;67 (7):902-4. DOI:10.1007/s12630-020-01649-w.Ong S.W.X., Tan Y.K., Chia P.Y. et al. Air, Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) From a Symptomatic Patient [published online ahead of print, 2020 Mar 4]. JAMA. 2020;323(16):1610-2. DOI:10.1001/jama.2020.3227.Kim D.J., Jelic T., Woo M.Y., Heslop C., Olszynski P. Just the Facts: Recommendations on point-of-care ultrasound use and machine infection control during the coronavirus disease 2019 pandemic [published online ahead of print, 2020 Apr 9]. CJEM. 2020;1-5. DOI:10.1017/cem.2020.364.Kamming D., Gardam M., Chung F. Anaesthesia and SARS. Br. J. Anaesth. 2003;90(6):715-8. DOI:10.1093/bja/aeg173.Caputo K.M., Byrick R., Chapman M.G., Orser B.J., Orser B.A. Intubation of SARS patients: infection and perspectives of healthcare workers. Can. J. Anaesth. 2006;53(2):122-9. DOI:10. 1007/BF03021815.Wax R.S., Christian M.D. 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.Koryachkin V.A., Chupris V.G., Cherny A.Zh., Kazarin V.S., Liskov M.A., Malevich G.M., Maltsev M.P. Systemic toxicity of local anesthetics during regional anesthesia in orthopedics and traumatology. Travmatologiya i ortopediya Rissii. 2015;75(1):129-35.Корячкин В.А., Чуприс В.Г., Черный А.Ж., Казарин В.С., Лиськов М.А., Малевич Г.М., Мальцев М.П. Системная токсичность местных анестетиков при регионарной анестезии в ортопедии и травматологии. Травматология и ортопедия России. 2015;7(1):129-35.