Perioperative anaesthetic challenges in coronavirus disease associated mucormycosis: A retrospective study

Mamta  Khandelwal; Sunita  Meena; Sanjay  Morwal; Priyanka  Jain; Yogesh Modi

doi:10.18231/j.joapr.2022.32.37

Authors

Mamta Khandelwal Department of Anesthesia, SMS Medical College and attached Hospital, Jaipur, Rajasthan
Sunita Meena Department of Anesthesia, SMS Medical College and attached Hospital, Jaipur, Rajasthan
Sanjay Morwal Department of Anesthesia, SMS Medical College and attached Hospital, Jaipur, Rajasthan
Priyanka Jain Department of Anesthesia, SMS Medical College and attached Hospital, Jaipur, Rajasthan https://orcid.org/0000-0002-3601-6798
Yogesh Modi Department of Anesthesia, SMS Medical College and attached Hospital, Jaipur, Rajasthan

DOI:

https://doi.org/10.18231/j.joapr.2022.32.37

Keywords:

Mucormycosis, covid-19

Abstract

Background & Aim: Mucormycosis is a life-threatening fungal infection that occurs in immune-compromised patients. There were large number of mucormycosis cases reported during COVID pandemic (2019-21) mainly as post COVID sequelae. In the present retrospective study we aimed to evaluate the perioperative challenges faced in the anaesthetic management of Coronavirus disease associated Mucormycosis (CAM) patients who underwent surgery under general anesthesia. Methods: The perioperative records of CAM patients who underwent surgery from May 2021-July 2021 for mucormycosis were reviewed and evaluated in terms of difficult bag mask ventilation, difficult intubation and other intraoperative and post-operative complications. Observation and Results: The incidence of CAM and its associated surgery was significantly more in males than females and the mean age of the patients was 50 years. In 39.8% patients we encountered difficult bag mask ventilation. and in 17.5% patients more than two attempts for intubation were required. Conclusion: Mucormycosis patients posted for surgery may pose various anesthetic challenges especially in airway management and anesthesiologists must be well prepared for it

Downloads

Download data is not yet available.

References

Kulkarni PK, Reddy NB, Shrinivas B, Takkalki VV. Anesthetic considerations in the management of mucormycosis. Int J Med Public Health,5, 387 – 390 (2015)

Pahade A, Chowdhury I, Mittal A, Mowar A. Functional Endoscopic Sinus Surgery for Rhino-orbital mucormycosis in a pediatric patient with Acute Lymphocytic Leukemia-Anaesthetic considerations. Journal of Anaesthesia and Critical Care Case Reports, 5(3), 13-15 (2019)

Cornely OA, Alastruey-Izquierdo A, Arenz D, Chen SCA et al. Mucormycosis ECMM MSG Global Guideline Writing Group. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis., 19 (12), e405-e421 (2019)

Garg D, Muthu V, Sehgal IS, Ramachandran R, Kaur H, Bhalla A, Puri GD, Chakrabarti A, Agarwal R. Coronavirus Disease (COVID-19) Associated Mucormycosis (CAM): Case Report and Systematic Review of Literature. Mycopathologia 186, 289-98. (2021).

Saldanha M, Reddy R, Vincent MJ. Paranasal Mucormycosis in COVID-19 Patient. Indian J Otolaryngol Head Neck Surg., 22, 1-4 (2021).

Maini A, Tomar G, Khanna D, Kini Y, Mehta H, Bhagyasree V. Sino-orbital mucormycosis in a COVID-19 patient: A case report. Int J Surg Case Rep., 82, 105957 (2021)

Gupta KK, Singh A, Kalia A, Kandhola R. Anaesthetic considerations for post-COVID-19 mucormycosis surgery- A case report and review of literature. Indian J Anaesth., 65(7), 545-547 (2021)

Solanki NM, Solanki RN, Madaliya AV, Jasoliya RH, Upadhyay DT. COVID-19-associated mucormycosis: an update of anesthetic management. Ain-Shams Journal of Anesthesiology., 14, 16 (2022)

Singh AK, Singh R, Joshi SR, Misra A. Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India. Diabetes Metab Syndr., 15(4), 102146 (2021).

Karaaslan E. Anesthetic management of rhino orbito cerebral mucormycosis: Focus on challenges. J Mycol Med, 29, 219-222 (2019)

Satish D, Joy D, Ross A, Balasubramanya. Mucormycosis coinfection associated with global COVID-19: a case series from India. Int J Otorhinolaryngol Head Neck Surg, 7, 815-820 (2021)

Malhotra N, Bajwa SJ, Joshi M, Mehdiratta L, Kurdi M. Second wave of COVID-19 pandemic and the surge of mucormycosis: Lessons learnt and future preparedness: Indian Society of Anaesthesiologists (ISA National) Advisory and Position Statement. Indian J Anaesth, 65, 427-33 (2021)