COVID-19 has changed surgery forever

The COVID-19 pandemic has transformed health care forever, including surgery, just as 9/11 changed airport security and AIDS/HIV altered blood draws and donation.

Although this new reality continues to evolve, many changes are likely to remain – possibly permanently – from requirements for patients and visitors to wear face masks at the hospital or ambulatory (outpatient) surgery center to pre-surgery COVID-19 testing, says the American Society of Anesthesiologists (ASA).

“It is very safe to have surgery, especially with all of the precautions in place,” said ASA President Beverly K. Philip, M.D., FACA, FASA.

“Surgeons, physician anesthesiologists, and other providers caring for patients wear extensive personal protective equipment (PPE) and assess each patient to ensure they receive the safest and most appropriate care.

Patients should feel safe and secure that they can have surgery when they need it.”

During Patient Safety Awareness Week, March 14-20, ASA provides answers to six top questions you may be asking ahead of your surgery:

1) Will I need a COVID-19 test before surgery? Although it will depend on the hospital or outpatient surgery center, it is likely you will be required to have a negative COVID-19 test before surgery for the foreseeable future.

If you need emergency surgery and you test positive or your results aren’t available quickly, your health care providers will perform the procedure, but will take extra precautions, such as using enhanced PPE and placing you in quarantine for recovery.

For non-urgent surgery, ASA recommends patients without symptoms of COVID-19 have a negative polymerase chain reaction (PCR) COVID-19 test prior to moving forward with the procedure.

2) Does COVID-19 or the vaccine interfere with anesthesia? There is no evidence that either COVID-19 or the vaccine interferes with anesthesia.

However, because surgery is stressful on the body and temporarily puts extra strain on your immune system, you should wait until you are fully recovered from COVID-19 or you are fully immunized after vaccination before proceeding with surgery, as noted below.

3) Is it safe to have surgery if I recently had COVID-19 or have been vaccinated? Yes, you can have essential or elective surgery once you have fully recovered from COVID-19.

The ASA recommends waiting from four weeks (if you had no symptoms or only mild symptoms) to 12 weeks (if you had been admitted to the ICU) to have surgery.

If you’ve been vaccinated, your surgery should be scheduled at least two weeks after your final dose so that you are fully protected.

4) Should I wait until I’m vaccinated before having surgery? If you are eligible for vaccination and are having non-emergency surgery such as hip or knee replacement, it may be wise to get vaccinated first.

If you are not yet eligible for the vaccine, talk to your surgeon or physician anesthesiologist about the best time to proceed.

5) Have rules for waiting rooms and mask-wearing changed forever? The days of families gathered in waiting rooms while their loved one has surgery are likely gone.

Some hospitals and ambulatory surgery centers don’t allow anyone to wait at the facility, requiring the patient to be dropped off and picked up at a designated entrance.

Others allow one person to wait for their loved one in a waiting room with socially distanced rules.

And it is likely patients and visitors will be required to wear a mask the entire time they are in the hospital or ambulatory surgery center.

6) Will scheduling or having surgery take longer now? This will depend on the hospital or ambulatory surgery center.

Most have added time between surgeries for increased cleaning, so your surgery may occur later in the day than it would have previously, or take longer to schedule.

Although the pandemic has created the need for more rules and guidelines, it’s important to remember surgery and health care in general are safe.