Treating postdural puncture headache in COVID-19 positive patient- is bilateral greater occipital nerve block the answer?

A Cross-Sectional Study to Ascertain the Effect of COVID-19 Pandemic on Regional Anaesthesia Practices Amongst Anaesthesiologists of India

Background and aims Regional anaesthesia has been advocated as a preferred modality during the coronavirus disease 2019 (COVID‑19) pandemic, but pursuing regional anaesthesia during COVID-19 is challenging. Our cross-sectional survey aimed to analyze the challenges in conducting regional anaesthesia and the alterations in practices imposed by the COVID‑19 pandemic across the nation. Material and methods The questionnaire was validated by seven experts. Following ethical approval and trial registration, this Google Forms-based survey was circulated to anaesthesiologists across the country via emails over 3 months (April 2021 to June 2021). Weekly reminders were sent to the non-responders till the desired sample size was attained, after which the survey was closed and responses were analyzed. Results Five hundred and thirty-two of 1100 anaesthesiologists completed the survey (48.3% response rate). Among the 532 respondents, 65.8% reported an increase in the use of regional anaesthesia due to the pandemic, with 77.4% reporting a change in practice. Almost 90% of the respondents used a dedicated operation theatre for all infected patients. Most respondents (75%) used disposable plastic drapes (75%) and full personal protective equipment (PPE) for COVID-19-positive patients during the procedure. However, using PPE resulted in poor vision due to fogging and multiple attempts and increased performance duration. Most respondents (74.4%) used gloves to maintain ultrasound probe sterility, while many other respondents (65.7%) used a sterile camera cover for the same. Many respondents ordered inflammatory markers during preoperative evaluation. Conclusion The present survey revealed that there was increased utilization of regional anaesthesia with increased utilization of PPE, sterility routines, and ordering of investigations. The use of PPE led to many challenges while performing regional anaesthesia. However, many deviations were identified from the accepted recommendations, and one needs to be aware of proper practices to achieve optimal patient outcomes and provider safety.