Urgent surgery for COVID-19-positive pediatric patient

Franchesca Rivera-Calonje; Shiu-Yi Emily Chen; Carl Lo; Sang Le; Makoto Nagoshi

doi:10.1186/s40981-021-00461-9

Urgent surgery for COVID-19-positive pediatric patient

JA Clin Rep. 2021 Jul 22;7(1):57. doi: 10.1186/s40981-021-00461-9.

Authors

Franchesca Rivera-Calonje¹, Shiu-Yi Emily Chen¹, Carl Lo¹, Sang Le¹, Makoto Nagoshi²

Affiliations

¹ Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, University of Southern California, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA.
² Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, University of Southern California, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA. mnagoshi@chla.usc.edu.

Abstract

Background: We present a case of COVID-19-positive pediatric patient for urgent urological surgery by spinal anesthesia to avoid aerosolizing procedure.

Case presentation: A 12-year-old, COVID-19-positive boy presented for urgent wound incision and drainage at the circumcision site. Our anesthetic plan consisted of spinal anesthesia with sedation. He was transported from the COVID-19 isolation floor to the negative pressure operating room. He was placed in lateral decubitus position and oxygen was delivered through facemask. Under sedation, spinal anesthesia was achieved at first attempt. The patient maintained spontaneous ventilation without airway intervention. Patient was recovered in the operation room then transported back to the floor.

Conclusion: Spinal anesthesia is a safe alternative to general endotracheal anesthesia for many pediatric urology procedures. Effective team communication and preparation are keys when caring COVID-19-positive patient in perioperative setting to avoid minimize the risk to healthcare providers.

Keywords: Airway management; COVID-19; Pediatric anesthesia; Perioperative management; Spinal anesthesia.