Recovery from anaesthesia in post-COVID-19 mucormycosis debridement surgery: An observational study

Abstract

Background: Mucormycosis has emerged as the most common lethal post-COVID-19 infection. Since the onset of the COVID-19 pandemic, anaesthesiologists have faced the challenge of anaesthetising post-COVID mucormycosis patients, which requires extensive surgical debridement. Various perioperative factors can have an impact on the recovery from the neuromuscular blockade of these patients. Aims and Objectives: This study was undertaken to observe the recovery pattern from the neuromuscular blockade and the impact of various factors on extubation time. Materials and Methods: The retrospective study included all post-COVID-19 mucormycosis patients who underwent debridement surgery under general anaesthesia in a tertiary referral hospital. All the pre-anaesthetic evaluation charts, treatment charts and anaesthetic management charts were reviewed. The following outcome variables at recovery from anaesthesia were noted: duration of surgery, duration of anaesthesia and extubation time. Results: A total of 72 patients underwent post-COVID-19 debridement surgery in the study period, of which 26 patients were excluded from the study and 46 patients were included in the analysis. The median extubation time was 32 min and interquartile range was 7–37 min. Seventeen (37%) patients were extubated in <15 min and 29 (63%) patients were extubated after 15 min. The shortest extubation time was 2 min, whereas the longest was 1440 min. Conclusion: Extubation time was prolonged when post-COVID patients underwent debridement surgery for rhino-orbito-cerebral mucormycosis. Although pre-operative and intraoperative factors can impact recovery from neuromuscular blockade, our study did not demonstrate such findings. Delayed extubation time may be related to the COVID illness rather than pre-operative risk factors.