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97 Abdominal wall blocks for emergency ileostomy operation in a patient with COVID-19 pneumonia
  1. BB Güven,
  2. T Erturk,
  3. T Güner and
  4. A Ersoy
  1. Sultan Abdulhamidhan Sample and Training Hospital, Istanbul, Turkey


Background and Aims The anesthesia method to be administered during emergency surgical procedures for COVID-19 pneumonia patients carries great importance for both patient and surgical team. Regional blocks are generally used to ensure postoperative analgesia after abdominal surgery with general anesthesia. In this case, involving a patient receiving anticoagulant treatment due to COVID-19 pneumonia with planned emergency operation, the aim was to present the anesthesia management with rectus sheath(RS) and transversus abdominis plane(TAP) block combination for the ileostomy operation.

Methods A 70-year-old male patient treated with lymphoma diagnosis for 1 year with known hypertension was admitted to a tertiary referral hospital with respiratory symptoms. Abdominal computed tomography identified a suspicious mass in the terminal ileum which probably caused the ileus tableau and emergency ileostomy operation was planned (figure 1).

A lateral TAP block was performed with 25 mL of 0.25% bupivacaine and an RS block with 15 mL of 1% lidocaine (figure 2). During the operation, which lasted 65 minutes, there was no hemodynamic instability, complications, or any other negative events.

Results Due to the administered blocks, the patient was not given general anesthesia. Hence, transmission was reduced by minimizing aerosol formation in terms of protecting health personnel and worsening of the patient’s pneumonia was prevented.

Conclusions The case is discussed in terms of regional anesthesia techniques offering a good alternative in appropriate cases for both employee and patient safety in the present day, when the whole world is affected by the COVID-19 pandemic.

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