News — If you don’t have COVID-19, you probably want to stay as far away from a hospital as possible right now. However, the fact is that some people still need emergency surgery. If you or a loved one are in this situation – for any reason – you should know that experts say regional anesthesia may be better than general anesthesia to keep everyone in the operating room safe.
During general anesthesia, the patient is unconscious and connected to a ventilator (breathing machine). In contrast, regional anesthesia involves numbing the specific region of the body that requires surgery – such as an arm or a knee. With regional anesthesia, patients can still be sedated (asleep) and won’t feel anything. The benefits, though, have to do with the safety of everyone in the room during the surgery and the potential for fewer complications after surgery.
General anesthesia can require a tube be placed in the patient’s airway or trachea, which leads to what is called aerosol generation. If the patient has any respiratory infection, the health care team can be exposed to the aerosols during insertion or removal of this breathing tube. Research has found that the odds of transmitting infection during breathing tube insertion is 6.6 times higher than without it. Regional anesthesia is also associated with a lower the risk of postoperative complications. For a patient with COVID-19, these risks are likely to be more significant due to ongoing chest infection.
For these and other reasons, physicians with the American Society of Regional Anesthesia and Pain Medicine (ASRA) and the European Society of Regional Anaesthesia and Pain Therapy (ESRA) recommend patients receive regional anesthesia whenever possible during the COVID outbreak.
The two groups have developed a set of to aid healthcare providers in caring for patients during COVID-19, which are available on the societies’ websites.
Patients and their loved ones are urged to ask their physicians about the possibility of receiving regional anesthesia rather than general anesthesia. Guidance authors Vishal Uppal, MBBS, FRCA, EDRA, and Hari K. P. Kalagara, MD, FCARCSI, EDRA, are available for interviews on how these recommendations affect patients.
Dr. Uppal is an assistant professor and director of the Regional Anesthesia Fellowship Program; Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University. Dr. Kalagara is an assistant professor at the University of Alabama at Birmingham with a special interest in regional anesthesia. Both are frequent faculty members and actively involved in ASRA.
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