Avoiding Aerosol Generation During Tracheostomy in COVID-19 Patients

We read with interest the article by Foster and colleagues.1 The authors discussed a novel approach to reducing the transmission of novel coronavirus disease (COVID-19) during tracheostomy. In this scenario, an anesthesiologist plays a very important role in incorporating various methods that can reduce aerosolization of secretion during tracheostomy. We would like to add some maneuvers by which aerosol formation and transmission can be further reduced: intravenous glycopyrrolate before tracheostomy for suspected or confirmed COVID-19 patients facilitates drying of secretion and decreases the risk of exposure to aerosols,2 and to facilitate tracheostomy, opioids should be given after muscle relaxant in order to avoid opioid-induced cough, which may generate a large amount of aerosol containing virus.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Letter Source Type: research