OPERATING ROOM MANAGEMENT AND ANESTHETIC APPROACH IN COVID-19 PANDEMIC

Öz

Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease caused by novel severe acute respiratory tract syndrome coronavirus 2 (SARS-CoV-2). It has led to a coronavirus pandemic all over the world. Hospitals are among the institutions that are at high risk and need to be managed well in terms of the COVID-19 outbreak. The most risky areas in hospitals are intensive care units and operating rooms. With the onset of the pandemic, all patients who require surgical intervention should be considered as potentially infected. In operating rooms, the operating room team (surgeon, nurse, anesthesiologist and other assistant healthcare personnel) should immediately implement transmission measures in the management of suspected / confirmed COVID-19 patients. Anesthesiologists in particular take a leading role in the perioperative management of COVID-19, as they are experienced and effective in airway control and patient and staff safety. In this article, the measures taken in our institution during the operation of suspected / confirmed COVID-19 patients and the success we have achieved as a result of these measures are examined.

Anahtar Kelimeler

• COVİD-19
• OPERATING ROOM
• ANESTHETIC APPROACH

COVİD-19 PANDEMİ SÜRECİNDE AMELİYATHANE YÖNETİMİ VE ANESTEZİK YAKLAŞIM

Öz

Koronavirüs hastalığı 2019 (COVID-19), yeni tip şiddetli akut solunum yolu sendromu koronavirüsü 2'nin (SARS-CoV-2) neden olduğu bulaşıcı bir solunum yolu hastalığıdır. Bu virüs tüm dünyada pandemiye yol açmıştır. Hastaneler COVID-19 salgını açısından yüksek riskli ve iyi yönetilmesi gereken kurumların başında gelmektedir. Hastanelerde de en riskli alanlar yoğun bakımlar ve ameliyathanelerdir. Salgının başlamasıyla birlikte cerrahi müdahale gerekli olan tüm hastalar, olası enfekte kabul edilerek hareket edilmelidir. Ameliyathane ekibi (cerrah, hemşire, anestezist ve diğer yardımcı sağlık personeli) olası/kesin tanılı COVID-19 hastaların yönetiminde bulaş önlemlerini acilen hayata geçirmelidir. Özellikle anestezistler havayolu ile hasta ve çalışan güvenliği açısından tecrübeli ve etkin olmaları nedeniyle, COVID-19 ‘un perioperatif yönetiminde lider rol üstlenmektedirler. Bu makalede, olası/kesin tanılı COVID-19 hastalarının ameliyat sürecinde kurumumuzda alınmış olan önlemler ve bu önlemler sonucu elde ettiğimiz başarının ortaya konması irdelenmiştir.

Anahtar Kelimeler

• COVİD- 19
• AMELİYATHANE
• ANESTEZİ YÖNETİMİ

Kaynakça

1. Referans1 World Health Organization. "Naming the coronavirus disease (COVID-19) and the virus that causes it." World Health Organization. 2020.https://www.who.int/emergencies/diseases/ novel-coronavirus-2019/technical guidance/naming-the-coronavirus-disease-(covid2019)-and-the-virus-that-causes-it. Erişim tarihi: Nisan 2021) .
2. Referans2 Hui DS, I Azhar E, Madani TA, Ntoumi F, Kock R, Dar O, et al. The Continuing 2019-nCoV Epidemic Threat of Novel Coronaviruses to Global Health-The Latest 2019 Novel Coronavirus Outbreak in Wuhan, China. International Journal of Infectious Diseases 2020; 91: 264-6.
3. Referans3 World Health Organization. WHO DirectorGeneral's opening remarks at the media briefing on COVID-19-11 March 2020. https://www.who.int/dg/speeches/detail/w ho-director-general-s-opening-remarks-at-themedia-briefing-on-covid-19---11-march-2020 Erişim tarihi: Nisan 2021
4. Referans4 https://covid19.who.int/ Erişim tarihi: Nisan 2021
5. Referans5. T.C. Sağlık Bakanlığı. Türkiye’deki Güncel Durum. https://covid19.saglik.gov.tr/ Erişim tarihi: Nisan 2021
6. Referans6 Center of Disease Control and Prevention (CDC). Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19 in Healthcare Settings. 2020. https://www.cdc.gov/coronavirus/2019- ncov/hcp/infection-controlrecommendations.,
7. Referans7 https://shgmhastahakdb.saglik.gov.tr/Eklenti/36865/0/elektif-islemlerin-ertelenmesi-ve-diger-tedbirlerpdf.pdf. Erişim tarihi: Nisan 2021
8. Referans8 Wong J, Yuan Goh Q, Tan EZ, Lie SA, Tay YC, N SY et al. Preparing for a COVID-19 Pandemic: a Review of Operating Room Outbreak Response Measures in a Large Tertiary Hospital in Singapore. Canadian Journal of Anesthesia 2020;67:732-45.

9. Referans9 Cai H, Chen Y, Chen Z, Fang Q, Han WI. et al. Liang T. (Ed). “Handbook of COVID-19 Prevention and Treatment”, The First Affiliated Hospital, Zhejiang University School of Medicine. 2020.
10. Referans10 T.C. Sağlık Bakanlığı. COVID-19 Kişisel Koruyucu Ekipman Giyme Çıkarma Talimatı. https://dosyamerkez.saglik.gov.tr/Eklenti/36977,covid-19-kisisel-koruyucu-ekipman-giyme-ve cikarma-talimatipdf. Erişim tarihi:Nisan 2021)
11. Referans11 Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Canadian Journal of Anesthesia 2020;12: 1-9 ).
12. Referans12 Kamer E, Çolak T. COVID-19 ile Enfekte Bir Hastasının Operasyona İhtiyacı Olduğunda Ne Yapmalıyız: Cerrahi Öncesi, Cerrahi Sırası ve Cerrahi Sonrası Rehberi. Turkish Journal of Colorectal Disease 2020; 30: 1-8.
13. Referans13 Karaca AS, Özmen MM, Uçar AD, Yastı AÇ, Demirer S. COVID-19’lu Hastalarda Genel Cerrahi Ameliyathane Uygulamaları. Turkish Journal of Surgery 2020;36(1):6-10.
14. Referans14 Dexter F, Parra MC, Brown JR, Loftus RW. Perioperative COVID-19 Defense: An Evidence-Based Approach for Optimization of Infection Control and Operating Room Management. Anesth Analg. 2020 Jul;131(1):37-42. doi: 10.1213/ANE.0000000000004829.
15. Referans15 T.C. Sağlık Bakanlığı. Acil anestezi yönetimi https://covid19.saglik.gov.tr/TR-66164/covid-19-acil-anestezi-yonetimi.html. Erişim tarihi: Nisan 2021
16. Referans16 Ti LK, Ang LS, Foong TW, Ng BS. What We Do When a COVID-19 Patient Needs an Operation: Operating Room Preparation and Guidance. Canadian Journal of Anesthesia 2020: 1-3).
17. Referans17 Halvachizadeh S, Teuber H, Cinelli P, F Allemann, Pape HC, Neuhaus V. Does the time of day in orthopedic trauma surgery affect mortality and complication rates? Patient Safety in Surgery. 2019; 13(8): 1-8.
18. Referans18 Peng PW, Ho PL, Hota SS. Outbreak of a new coronavirus: what anaesthetists should know. British Journal of Anaesthesia. 2020; 124 (5): 497- 501.
19. Referans19 Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. Journal of Hospital Infection 2020; DOI: https://doi.org/10.1016/ j.jhin.2020.01.022.