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. 2025 Jun 5:12:1548043.
doi: 10.3389/fmed.2025.1548043. eCollection 2025.

Trends in surgery and anesthesia practices during the COVID-19 pandemic: a nationwide analysis from South Korea's Health Insurance Database

EunJin Ahn  1   2 , Hyo Jin Kim  1   2 , Si Ra Bang  1   2
Affiliations

Trends in surgery and anesthesia practices during the COVID-19 pandemic: a nationwide analysis from South Korea's Health Insurance Database

EunJin Ahn et al. Front Med (Lausanne). .

Abstract

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has led to significant changes to global healthcare systems, particularly affecting surgical and anesthetic practices. This study investigated nationwide trend in anesthesia and surgery before and during the pandemic.

Methods: This retrospective, population-based study analyzed confirmed COVID-19 cases in the Korean National Health Information Database from 2019 to 2021. Anesthesia procedures were categorized into general anesthesia, regional anesthesia, and monitored anesthesia care (MAC). COVID-19 positive patients were defined as those with a confirmed diagnosis within 30 days before and after surgery. We analyzed anesthesia modality, patient characteristics, hospital type and COVID-19 trends.

Results: A total of 6,878,556 anesthesia procedures were recorded. The number of procedures decreased slightly in 2020 but increased in 2021. General anesthesia accounted for the majority of procedures. Regional anesthesia, especially brachial plexus block (BPB), and MAC showed an increasing trend. There was a positive correlation between monthly COVID-19 case counts and surgical volume. Most COVID-19 positive patients underwent surgery in general hospitals and received general anesthesia.

Conclusion: Despite the pandemic, overall surgical volume in South Korea remained relatively stable compared to global trends. The shift toward regional techniques like BPB suggests adaptation to reduce aerosol-generating procedures. These findings highlight the need for strategic allocation of resources and preparedness planning in future pandemics.

Keywords: COVID-19; anesthesia; healthcare; pandemic; surgery.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Number of surgeries performed with anesthesia during the coronavirus disease 2019 (COVID-19) pandemic: monthly and yearly variations. (A) Total number of cases, including general anesthesia, regional anesthesia, and monitored anesthesia care. (B) Number of general anesthesia cases. (C) Number of regional anesthesia cases. (D) Number of monitored anesthesia care cases.
FIGURE 2
FIGURE 2
Correlation between the number of surgeries performed among coronavirus disease 2019 (COVID-19)-confirmed cases and the number of patients with COVID-19. (A) Monthly changes in the number of surgeries performed among COVID-19-confirmed cases and the number of patients with COVID-19. (B) Scatter plot.
FIGURE 3
FIGURE 3
Correlation between the number of surgeries performed and the number of patients with coronavirus disease 2019 (COVID-19). (A) Monthly changes in the number of surgeries performed during the COVID-19 era and the number of patients with COVID-19. (B) Scatter plot.
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