{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T16:42:57Z","timestamp":1789922577656,"version":"4.0.1"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>COVID 19 pandemic caused by severe acute respiratory syndrome coronavirus -2 has proven to be the deadliest pandemic till date. Multiple covid waves have hit people hard on each part of the continent throughout the world. The second wave in India turned out to be highly infectious and virulent. Sudden surge in cases of mucormycosis after recovery of COVID surprised many clinician. Mucormycosis being a rapidly progressive and fulminant fungal infection required surgical debridement of necrotic tissue on emergency basis. The fatal combination of immunocompromised status, multisystemic involvement, and difficult airway in these patients pose numerous new challenges regarding anesthetic management. The present study was conducted to outline major concerns and the anesthetic management of patients undergoing surgical resection for rhinoorbital mucormycosis (ROM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A retrospective observational study was conducted in our institute for a duration of 2 months (June and July 2021). The data of all the cases posted for ROM was collected from the ENT and Anesthesia record register. Total 70 patients presented with mucormycosis, for surgical debridement out of which 25 patients were posted for surgery under general anesthesia or monitored anesthesia care (MAC). Demographic characteristics, comorbidities, duration of COVID illness, treatment taken during COVID (oxygen therapy\/steroid intake), hemodynamic parameters, monitoring methods, and surgical procedures were recorded for each patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Evaluation:<\/jats:title>\n                    <jats:p>\n                      SPSS version 21.0 was used for data analysis. Mean and SD were used to analyze the difference in mean values, and independent Student's\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -test were utilized to compare the quantitative variables. Frequency distribution and percentage were used for qualitative parameters. Significant difference was accepted at\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2264 0.05 with 95% CI (confidence interval) in the study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Demographic data were comparable with respect to age, gender distribution, and ASA status. Mean duration of Covid illness was (12.18 \u00b1 3.68) days. The mean HbA1C measured was (10.8 \u00b1 1.42). Strong correlation was found between steroid intake and raised HbA1c in all patients (r = 0.77). Regarding the comorbidities, 24 (96%) patients had associated type 2 diabetes mellitus, 16 patients (64%) had pneumonitis, and 1 patient had pulmonary TB and hepatitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Considering the perioperative risk associated with high HbA1C and pneumonitis, MAC was preferred in majority of cases. Strict hemodynamic monitoring, perioperative glucose control, difficult airway cart, metabolic and electrolyte balance and vigilant peri-operative monitoring are cornerstone for better outcome and short length of hospital stay.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sja.sja_783_21","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T02:03:04Z","timestamp":1647568984000},"page":"176-181","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Perioperative anesthetic concerns in postcovid mucormycosis patients posted for surgical intervention"],"prefix":"10.4103","volume":"16","author":[{"given":"Shilpi","family":"Misra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivani","family":"Rastogi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Malviya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachana","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep K.","family":"Yadav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharif","family":"Alam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-7-20240909","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.jiph.2012.01.003","article-title":"Cerebro-rhino orbital mucormycosis: An update","volume":"5","author":"Wali","year":"2012","journal-title":"J Infect Public Health"},{"key":"R2-7-20240909","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s11908-010-0162-8","article-title":"Mucormycosis of the head and neck","volume":"13","author":"Michael","year":"2011","journal-title":"Curr Infect Dis Rep"},{"key":"R3-7-20240909","doi-asserted-by":"crossref","first-page":"e69","DOI":"10.1016\/j.tripleo.2011.04.048","article-title":"Management and outcomes of three cases of rhinocerebral mucormycosis","volume":"112","author":"Viterbo","year":"2011","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"R4-7-20240909","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1128\/CMR.18.3.556-569.2005","article-title":"Novel perspectives on mucormycosis: Pathophysiology, presentation, and management","volume":"18","author":"Spellberg","year":"2005","journal-title":"Clin Microbiol Rev"},{"key":"R6-7-20240909","first-page":"5","article-title":"Rhino-orbital mucormycosis","volume":"10","author":"Dash","year":"2013","journal-title":"Natl J Otorhinolaryngol Head Neck Surg"},{"key":"R7-7-20240909","first-page":"729","article-title":"Mucormycosissupraglottitison induction of anesthesia in an immunocompromised host","volume":"86","author":"Eckmann","year":"1998","journal-title":"Anesth Analg"},{"key":"R8-7-20240909","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.mycmed.2019.07.001","article-title":"Anesthetic management of rhinoorbitocerebral mucormycosis; Focus on challenges","volume":"29","author":"Karaaslan","year":"2019","journal-title":"J Mycol Med"},{"key":"R9-7-20240909","doi-asserted-by":"crossref","first-page":"i108","DOI":"10.1093\/bja\/aeq299","article-title":"Lung protective strategies in anaesthesia","volume":"105","author":"Kilpatrick","year":"2010","journal-title":"Anaesth"},{"key":"R10-7-20240909","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/1479-5876-4-46","article-title":"Antimicrobial effects of liquid anesthetic isoflurane on Candida albicans?","volume":"9","author":"Barodka","year":"2006","journal-title":"J Transl Med"},{"key":"R11-7-20240909","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/ALN.0b013e31827773b2","article-title":"Practice guidelines for management of the difficult airway: An updated report by the American Society of Anesthesiologists Task Force on management of the difficult airway","volume":"118","author":"Apfelbaum","year":"2013","journal-title":"Anesthesiology"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_783_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:08:42Z","timestamp":1787166522000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_783_21"}},"subtitle":["An observational Study"],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_783_21","relation":{},"ISSN":["1658-354X"],"issn-type":[{"value":"1658-354X","type":"print"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}