Chloé Damman, Guillaume Lemaire, Fabienne RoelantsPublished in the journal : May 2020Category : Anesthésie
In March 2020, the COVID-19 outbreak enforced the initiation of the Hospital Emergency Plan in Belgian hospitals. The anesthesiology department of the Cliniques universitaires Saint-Luc (CUSL) was invited to develop strategies designed to adapt the workflow at an ever increasing pace and ensure an optimal provision of care. Among these strategies was the reorganization of the operating room and maternity department, along with their respective staff, introduction of personal protective equipment, formulation of guidelines for anesthetic management, as well as simulation exercises in order to train and prepare staff.
These measures were deemed necessary in order to assure the quality of care and reduce the risk of transmission to other patients or healthcare workers.
A 50-year-old man with a complete medullary section at the old C6-C7 level and suspicion of autonomic hyperreflexia (HA) was assumed to benefit from cystectomy with Bricker-type non-continent urinary diversion. In addition to general anesthesia, thoracic epidural analgesia and intravenous lidocaine were used to prevent HA during the operative period, facilitating postoperative rehabilitation. The patient remained stable throughout the procedure, without any major problems postoperatively. Oral feeding was started on Day 3. The article describes the benefits of epidural analgesia and intravenous lidocaine for managing patients at risk for HA.