Neuroanesthesia Practice During the COVID-19 Pandemic: Recommendations From Society for Neuroscience in Anesthesiology and Critical Care (SNACC)

Abstract

The pandemic of coronavirus disease 2019 (COVID-19) has several implications relevant to neuroanesthesiologists, including neurological manifestations of the disease, impact of anesthesia provision for specific neurosurgical procedures and electroconvulsive therapy, and health care provider wellness. The Society for Neuroscience in Anesthesiology and Critical Care appointed a task force to provide timely, consensus-based expert guidance for neuroanesthesiologists during the COVID-19 pandemic. The aim of this document is to provide a focused overview of COVID-19 disease relevant to neuroanesthesia practice. This consensus statement provides information on the neurological manifestations of COVID-19, advice for neuroanesthesia clinical practice during emergent neurosurgery, interventional radiology (excluding endovascular treatment of acute ischemic stroke), transnasal neurosurgery, awake craniotomy and electroconvulsive therapy, as well as information about health care provider wellness. Institutions and health care providers are encouraged to adapt these recommendations to best suit local needs, considering existing practice standards and resource availability to ensure safety of patients and providers.

FIGURE 1

Summary of recommendations for the anesthetic management of urgent neurosurgical procedures during the COVID-19 pandemic. PAPR indicates powered, air-purifying respirator; PPE, personal protective equipment; RT-qPCR, real-time quantitative fluorescence polymerase chain reaction.

FIGURE 2

Summary of recommendations for the anesthetic management of ECT during the COVID-19 pandemic. ECT indicates electroconvulsive therapy; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.