Perioperative Management of Suspected/Confirmed cases of COVID-19 in the Indian Scenario

The novel coronavirus, 2019-nCoV (COVID-19) a zoonotic virus is transmitted during unprotected close contact from an infected individual through droplets and fomites. The COVID-19 poses tremendous challenge for the healthcare sector globally. Anesthesiologists are at a higher risk than healthcare professionals of any other speciality because they manoeuvre the airway and ventilation and perform a whole gamut of aerosol generating procedures. Moreover, with all the emergency patients who need surgery being considered as suspects of COVID-19 under the present circumstances, there is an urgent need for development of safe medical practices and infection prevention protocol for the perioperative management of patients with COVID-19. In resource limited settings like India, where the government hospitals and the large private healthcare providers are struggling to provide adequate PPE, with many anesthesiologists working in small hospitals, it is all the more important to customise the existing guidelines according to the available infrastructure keeping the basic rationale of the precautions intact. Modifications in airway management and anesthesia practise are required to minimise aerosol generation. Regional anaesthesia should be the preferred choice wherever possible. Planned perioperative care can minimise disease transmission. Crisis capacity Strategies as per CDC recommendations to ensure smooth supply and use of Personal Protective Equipment in resource limited settings is necessary.