Perioperative COVID-19 Defense: An Evidence-Based Approach for Optimization of Infection Control and Operating Room Management

Franklin Dexter, MD, PhD, FASA; Michelle C. Parra, MD; Jeremiah R. Brown, PhD; Randy W. Loftus, MD


Anesth Analg. 2020;131(1):37-42. 

In This Article

Or Management Strategies During the COVID-19 Crisis

In the setting of a viral pandemic, operative procedures are limited to essential interventions such as urgent and emergent procedures. Essential operations include a patient needing a biopsy to initiate medical or radiation treatments. Restriction of procedures has substantial clinical and management implications. Previous OR management reports have not defined the best strategy for assigning personnel and cases to ORs under these unique circumstances. Factors to consider are limited resources balanced with the simultaneous goal to minimize both patient and provider exposure to high-risk pathogen transmission and probable infection. We consider the likelihood of pathogen transmission during routine patient care to the surrounding environment as the most potent transmission vehicle in the OR.[8] Moreover, we now recognize the extended environmental survival of such transmitted pathogens (eg, at least 3 days for COVID-19).[5] Given these circumstances, how should one schedule essential cases to minimize short- and long-term risk of transmission to patients and their providers? In the analysis below, we describe the proper approach for management of patients in the COVID-19 era.