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Review
. 2020 Oct;45(10):831-834.
doi: 10.1136/rapm-2020-101653. Epub 2020 May 23.

Daring discourse: are we ready to recommend neuraxial anesthesia and peripheral nerve blocks during the COVID-19 pandemic? A pro-con

Michael N Singleton  1 , Ellen M Soffin  2
Affiliations
Review

Daring discourse: are we ready to recommend neuraxial anesthesia and peripheral nerve blocks during the COVID-19 pandemic? A pro-con

Michael N Singleton et al. Reg Anesth Pain Med. 2020 Oct.

Abstract

The recent joint statement from the American Society of Regional Anesthesia and Pain Medicine (ASRA) and the European Society of Regional Anesthesia and Pain Therapy (ESRA) recommends neuraxial and peripheral nerve blocks for patients with coronavirus disease 2019 (COVID-2019) illness. The benefits of regional anesthetic and analgesic techniques on patient outcomes and healthcare systems are evident. Regional techniques are now additionally promoted as a mechanism to reduce aerosolizing procedures. However, caring for patients with COVID-19 illness requires rapid redefinition of risks and benefits-both for patients and practitioners. These should be fully considered within the context of available evidence and expert opinion. In this Daring Discourse, we present two opposing perspectives on adopting the ASRA/ESRA recommendation. Areas of controversy in the literature and opportunities for research to address knowledge gaps are highlighted. We hope this will stimulate dialogue and research into the optimal techniques to improve patient outcomes and ensure practitioner safety during the pandemic.

Keywords: anesthesia; local; nerve block; postoperative complications; regional anesthesia.

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Conflict of interest statement

Competing interests: None declared.

References

    1. Memtsoudis SG, Cozowicz C, Bekeris J, et al. . Anaesthetic care of patients undergoing primary hip and knee arthroplasty: consensus recommendations from the International consensus on Anaesthesia-Related outcomes after surgery group (ICAROS) based on a systematic review and meta-analysis. Br J Anaesth 2019;123:269–87. 10.1016/j.bja.2019.05.042 - DOI - PMC - PubMed
    1. Wedel DJ, Horlocker TT. Regional anesthesia in the febrile or infected patient. Reg Anesth Pain Med 2006;31:324–33. 10.1097/00115550-200607000-00007 - DOI - PubMed
    1. Uppal V, Sondekoppam R, Lobo C, et al. . Practice recommendations on neuraxial anesthesia and peripheral blocks during the COVID-19 pandemic. A joint statement by the American Society of regional anesthesia and pain medicine (ASRA) and European Society of regional anesthesia and pain therapy (ESRA), 2020. Available: https://www.asra.com/page/2905/practice-recommendations-on-neuraxial-ane... [Accessed Apr 2020].
    1. Fanaroff AC, Califf RM, Windecker S, et al. . Levels of evidence supporting American College of Cardiology/American heart association and European Society of cardiology guidelines, 2008-2018. JAMA 2019;321:1069–80. 10.1001/jama.2019.1122 - DOI - PMC - PubMed
    1. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task force on obstetric anesthesia and the Society for obstetric anesthesia and Perinatology. Anesthesiology 2016;124:270–300. 10.1097/ALN.0000000000000935 - DOI - PubMed

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