Anaesthetic managment and clinical outcomes of parturients with COVID-19: a multicentre, retrospective, propensity score matched cohort study

Yuan Zhang; Rong Chen; Jie Wang; Yuan Gong; Qin Zhou; Hui-hui Cheng; Zhong-yuan Xia; Xiangdong Chen; Qing-tao Meng; Daqing Ma

In the period of COVID-19 outbreak, routine prenatal examination was limited by traffic control and isolation policy in place, and hence pathological pregnancy can't be found timely, which may be the reasons for the high emergency caesarean delivery and general anaesthesia use in the COVID-19 patients in this study. Although general anaesthesia would induce or exacerbate pulmonary complications in parturients 11 with COVID-19, the cesarean delivery under general anaesthesia is necessarily to be used for fetal distress, potential contraindication of intrathecal anaesthesia, as well as intrathecal anaesthesia failure. The rapid-sequence induction by using propofol, rocuronium and remifentanil was used in our COVID-19 patients and the excellent maternal hemodynamic stability was noted. However, the possible risk of short-time neonatal depression and required short periods of mask ventilation or tactile stimulation of the neonate were found. However, in this study, either intravenous or inhalational induction was not difference in term of the safety of maternal and neonatal and the risk infection of medical staff. To avoid hemorrhage resulted from uterine atony, inhalational sevoflurane was switched into intravenous anaesthetics after umbilical cordligation. Notably, PPE increased the difficult in airway management and it was necessary for the use of visual laryngoscopes, and the supraglottic airway was considered as a remedy for failed tracheal intubation in emergency general anaesthesia 12 .