Quantitative analysis of loss of anesthesia management opportunities and procedural skills due to COVID-19 pandemic lockdown: An experience of six months from a tertiary care cancer teaching institute.

Background And Aims: COVID-19 has necessitated restrictions on elective surgical workload, which could adversely affect the learning of the core clinical competencies of the postgraduate anesthesiology trainees. The aim was to assess and compare the loss of elective cases requiring anesthesia management and associated procedural skills in six months since lockdown compared to the same duration in 2019.

Material And Methods: We compared the data, obtained from electronic medical records, of the total number of elective surgeries requiring anesthesia management and the following procedural skills in both adults and pediatric patients in 6 months duration in 2019 and 2020: 1) Laryngoscopy and Intubation 2) Laryngeal mask airway 3) Arterial and central line cannulations and 4) Spinal, Epidural, Other Regional blocks.

Results: A total of 8458 and 3561 elective procedures were performed in the six-month period in 2019 and 2020 respectively, reflecting a 57.9% reduction due to lockdown. There was a proportionate reduction in the adult and pediatric procedures, operating room and non-operating room procedures, and surgeries performed under general anesthesia and monitored anesthesia care. There was a significant increase in the number of surgeries performed under regional anesthesia (486%). Epidurals blocks and other regional blocks also showed a proportionate reduction respectively. Although the total number of video-laryngoscopy assisted intubations show an absolute reduction, when compared to the total number of cases performed in the respective years, we found an increase (2.06% in 2019 vs 3.8% in 2020). The arterial cannulations reduced by 43.29% but the central line cannulations reduced by only 12.28%.

Conclusion: There was a significant reduction in both the anesthesia management opportunities and in the total number of associated procedural skills due to COVID-19 lockdown which could adversely affect the learning of core clinical competencies of postgraduate trainees.