Open Appendicectomy under Spinal Anesthesia-A Valuable Alternative during COVID-19.

The Surgery Journal
Dinh Van Chi MaiBarrie D Keeler

Abstract

Introduction  Concerns relating to coronavirus disease 2019 (COVID-19) and general anesthesia (GA) prompted our department to consider that open appendicectomy under spinal anesthesia (SA) avoids aerosolization from intubation and laparoscopy. While common in developing nations, it is unusual in the United Kingdom. We present the first United Kingdom case series and discuss its potential role during and after this pandemic. Methods  We prospectively studied patients with appendicitis at a British district general hospital who were unsuitable for conservative management and consequently underwent open appendicectomy under SA. We also reviewed patient satisfaction after 30 days. This ran for 5 weeks from March 25th, 2020 until the surgical department reverted to the laparoscopic appendicectomy as the standard of care. Main outcomes were 30-day complication rates and patient satisfaction. Results  None of the included seven patients were COVID positive. The majority (four-sevenths) had complicated appendicitis. There were no major adverse (Clavien-Dindo grade III to V) postoperative events. Two patients suffered minor postoperative complications. Two experienced intraoperative pain. Mean operative time was 44 minutes. Median lengt...Continue Reading

References

Jul 30, 2009·Annals of Surgery·Pierre A ClavienMasatoshi Makuuchi
Dec 5, 2019·The British Journal of Surgery·A Bhangu, UNKNOWN RIFT Study Group on behalf of the West Midlands Research Collaborative
Mar 18, 2020·The New England Journal of Medicine·Neeltje van DoremalenVincent J Munster
May 29, 2020·The British Journal of Surgery·UNKNOWN HAREM Steering Group
Mar 25, 2021·Annals of Surgery·Federico CoccoliniMassimo Chiarugi

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