key: cord-0974805-bvky1cui
authors: Yue, Linli; Han, Lefei; Li, Qiannan; Zhong, Min; Wang, Jun; Wan, Zhenzhen; Chu, Caijuan; Zeng, Yi; Peng, Min; Li, Na; Yang, Lin
title: Anesthesia and infection control in cesarean section of pregnant women with COVID-19 infection: A descriptive study
date: 2020-05-28
journal: J Clin Anesth
DOI: 10.1016/j.jclinane.2020.109908
sha: 7477548ca75b2cc5ae6b50e2e5b1a005048182fa
doc_id: 974805
cord_uid: bvky1cui

nan

Anesthesiologists had a high exposure risk to SARS-CoV-2 when conducting cesarean section for pregnant women with COVID-19. In response, we upgraded infection prevention and control (IPC) practice to the highest level according to the national guideline [1] . One negative pressure operating room was dedicated to all operations on pregnant women with confirmed COVID-19 pneumonia. Pregnant women with confirmed and suspected COVID-19 were required to wear a surgical mask upon arrival to operation room during surgery.

They were moved to isolation wards immediately after surgery. Some newborns stayed in neonatal wards and others were sent home to be taken care by family members.

Here we reported the safety and efficacy of the combined spinal-epidural anesthesia The requirement for written informed consent was waived by the Ethics Committee since the data were encrypted.

We followed a standard protocol of the CSEA procedure in our hospital. Intraspinal anesthesia (0.5% ropivacaine at 10-15mg) was administered using pencil-point spinal needles at L2-3. An epidural catheter was inserted toward the head as a rescue pathway during operation and also for postoperative analgesia. For postoperative analgesia, dezocine (5mg/ml) at 5-10mg was immediately administered by intravenous infusion after delivery, We previously reported that COVID-19 infection caused relatively mild symptoms in pregnant women, who rarely had hypoxia or respiratory failure. The maternal and neonatal outcomes were also comparable to other pregnant women without infection [4] . Another study in Wuhan reported that 12 out of 14 pregnant women experienced hypotension during the cesarean section under epidural anesthesia [5] . However, very few incidences of hypotension had occurred in our patients (zero in confirmed cases, and 4 out of 16 in suspected ones). This could be owing to administration of dezocine and morphine in our anesthesia procedure, but it requires further investigations from more studies. 

National Health Commission of China. Infection prevention and control guidelines for novel coronavirus in healthcare settings

Pharmacological Characterization of Dezocine, a Potent Analgesic Acting as a kappa

Comparison of the efficacy and safety between dezocine injection and morphine injection for persistence of pain in Chinese cancer patients: a meta-analysis

Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study

Safety and efficacy of different anesthetic regimens for parturients with COVID-19 undergoing Cesarean delivery: a case series of 17 patients

The authors report no potential conflicts of interest.