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B433 Pediatric anesthesia practices during the COVID-19 pandemic
  1. K DelPizzo1,2,
  2. J Ruby1,2,
  3. A Illescas1,
  4. H Zhong1,
  5. J Poeran3,
  6. J Liu1,2,
  7. C Cozowicz4 and
  8. S Memtsoudis1,2,5
  1. 1Hospital for Special Surgery, New York, USA
  2. 2Weill Cornell Medicine, New York, USA
  3. 3Icahn School of Medicine at Mount Sinai, New York, USA
  4. 4Paracelsus Medical University, Salzburg, Austria
  5. 5Weill Cornell Medical College, New York, USA


Background and Aims The onset of the coronavirus 2019 (COVID-19) pandemic brought together the American Society of Regional Anesthesia and Pain Medicine (ASRA) and the European Society of Regional Anaesthesia and Pain Therapy (ESRA) to release a joint statement on anesthesia use (1). Their statement included a recommendation to use regional anesthesia whenever possible to mitigate the risk associated with aerosolizing procedures. We sought to examine the utilization of anesthesia in pediatric patients undergoing a surgical procedure for fracture or ligament repair before and during COVID-19.

Methods This study is approved by Hospital for Special Surgery Institutional Review Board (IRB# 2016–436). We used the Premier Healthcare Database to identify pediatric patients undergoing a surgical intervention for fractures or ligament repair before COVID-19 (March-June 2019) and during (March-June 2020). We compared general, regional, and combined general-regional use before and during COVID-19.

Results We identified 6,415 patients undergoing a surgical procedure for fracture or ligament repair before and during COVID-19. After exclusions for unknown anesthesia use, 3,052 patients were included in our cohort with 82.9% (n=2,530) of patients undergoing a procedure under general anesthesia, 6.0% (n=182) under regional anesthesia, and 11.1% (n=340) under combined general-regional anesthesia. There was no difference in the type of anesthesia used before and during COVID-19 (p=0.053, Table 1).

Conclusions We did not find a significant difference in anesthesia use before and during COVID-19 among pediatric patients undergoing a surgical procedure. The significance of these findings highlights how societal recommendations and historical precedent may not influence pediatric anesthesia practice models.

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