(Ong Sharon) - Singapore General Hospital Division of Anesthesiology and Perioperative Sciences
(Lim Wan Yen) - Singapore General Hospital Division of Anesthesiology and Perioperative Sciences
(Ong John) - University of Cambridge Department of Engineering
(Kam Peter) - University of Sydney Faculty of Medicine and Health Royal Prince Alfred Hospital Department of Anesthetics
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has challenged health systems globally and prompted the publication of several guidelines. The experiences of our international colleagues should be utilized to protect patients and healthcare workers. The primary aim of this article is to appraise national guidelines for the perioperative anesthetic management of patients with COVID-19 so that they can be enhanced for the management of any resurgence of the epidemic. PubMed and EMBASE databases were systematically searched for guidelines related to SARS-CoV and SARS-CoV-2. Additionally, the World Federation Society of Anesthesiologists COVID-19 resource webpage was searched for national guidelines; the search was expanded to include countries with a high incidence of SARS-CoV. The guidelines were evaluated using the Appraisal of Guidelines for Research and Evaluation II tool. Guidelines from Australia, Canada, China, India, Italy, South Africa, South Korea, Taiwan, the United Kingdom, and the United States of America were evaluated. All the guidelines focused predominantly on intubation and infection control. The scope and purpose of guidelines from China were the most comprehensive. The UK and South Africa provided the best clarity. Editorial independence, the rigor of development, and applicability scored poorly. Heterogeneity and gaps pertaining to preoperative screening, anesthesia technique, subspecialty anesthesia, and the lack of auditing of guidelines were identified. Evidence supporting the recommendations was weak. Early guidelines for the anesthetic management of COVID-19 patients lacked quality and a robust reporting framework. As new evidence emerges, national guidelines should be updated to enhance rigor, clarity, and applicability.
Å°¿öµå
Anesthesia, Coronavirus infections, COVID-19, Guidelines, Perioperative management, Perioperative medicine, Review
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸
À¯È¿¼º°á°ú(Recomendation)
Nineteen national guidelines from Australia, Canada, China, India, Italy, South Africa, South Korea, Taiwan, the UK, and the USA described the anesthetic management of COVID-19 patients; National anesthetic guidelines published in the early phase of the COVID-19 pandemic were largely guided by weak evidence, and they lacked robust reporting.