Intraoperative and Postoperative Factors Tend to Decrease in Oxygen Saturation in Postanesthesia Care Unit

Document Type : Original Article (s)

Authors

1 Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: We aimed to investigate intraoperative and postoperative factors tend to decrease in oxygen saturation in postanesthesia care unit (PACU).Methods: In this observational study, body temperature, systolic and diastolic blood pressure, mean arterial pressure, respiratory rate, pulse rate, O2 saturation, needs for using nitrous oxide (N2O), needs for positive end-expiratory pressure (PEEP), liquid volume used for each patients during surgery, mean patient's blood loss, type of blood products used during surgery, snoring, type of anesthetic medications, time duration of surgery, and site of operation in patient's body were recorded during and after operation. Patients were divided into two groups that experienced oxygen desaturation and those did not. All the variables were compared between the two groups.Findings: From 500 patients participated in this study, 50 participants (10%) experienced oxygen desaturation, while 445 cases (89%) did not, and 5 patients (1%) had uncertain condition for oxygen saturation. Significantly higher variables in the group with oxygen desaturation were as pulse rate during the surgery (P = 0.009), mean liquid volume (P = 0.029), pain and its severity (P = 0.001 for both), and snoring (P = 0.020). There was a significant relation between presence of oxygen desaturation and having operation on thorax (60%), upper abdomen (40%), and spine (39%) (P = 0.001).Conclusion: Pulse rate during the surgery, liquid volume used during surgery, using N2O, not using PEEP, pain and its severity, and snoring in PACU are associated with experiencing oxygen desaturation.

Keywords

References

  1. Miller R, Pardo M. Basics of anesthesia. 6th ed. Philadelphia, PA: Saunders; 2011. p. 817.
  2. Gift AG, Stanik J, Karpenick J, Whitmore K, Bolgiano CS. Oxygen saturation in postoperative patients at low risk for hypoxemia: is oxygen therapy needed? Anesth Analg 1995; 80(2): 368-72.
  3. Sear JW. Oxygen: needed for life. But do we need supplemental oxygen during transfer from the OR to the PACU? J Clin Anesth 2013; 25(8): 609-11.
  4. Hedenstierna G. Oxygen and anesthesia: What lung do we deliver to the post-operative ward? Acta Anaesthesiol Scand 2012; 56(6): 675-85.
  5. Siddiqui N, Arzola C, Teresi J, Fox G, Guerina L, Friedman Z. Predictors of desaturation in the postoperative anesthesia care unit: An observational study. J Clin Anesth 2013; 25(8): 612-7.
  6. Pereira H, Xara D, Mendonca J, Santos A, Abelha FJ. Patients with a high risk for obstructive sleep apnea syndrome: postoperative respiratory complications. Rev Port Pneumol 2013; 19(4): 144-51.
  7. Canet J, Ricos M, Vidal F. Early postoperative arterial oxygen desaturation. Determining factors and response to oxygen therapy. Anesth Analg 1989; 69(2): 207-12.
  8. Daley MD, Norman PH, Colmenares ME, Sandler AN. Hypoxaemia in adults in the post-anaesthesia care unit. Can J Anaesth 1991; 38(6): 740-6.
  9. Rosenberg J, Dirkes WE, Kehlet H. Episodic arterial oxygen desaturation and heart rate variations following major abdominal surgery. Br J Anaesth 1989; 63(6): 651-4.
  10. Meiklejohn BH, Smith G, Elling AE, Hindocha N. Arterial oxygen desaturation during postoperative transportation: the influence of operation site. Anaesthesia 1987; 42(12): 1313-5.
  11. Catley DM, Thornton C, Jordan C, Lehane JR, Royston D, Jones JG. Pronounced, episodic oxygen desaturation in the postoperative period: its association with ventilatory pattern and analgesic regimen. Anesthesiology 1985; 63(1): 20-8.
  12. Beaussier M, Genty T, Lescot T, Aissou M. Influence of pain on postoperative ventilatory disturbances. Management and expected benefits. Ann Fr Anesth Reanim 2014; 33(7-8): 484-6.
  13. Charuluxananan S, Suraseranivongse S, Punjasawadwong Y, Somboonviboon W, Sriswasdi S, Pranootnarabhal T, et al. Risk factors of intraoperative oxygen desaturation: a case-control study of 152,314 anesthetics. J Med Assoc Thai 2007; 90(11): 2359-65.
  14. Aggarwal S, Goyal VK, Chaturvedi SK, Mathur V, Baj B, Kumar A. A comparative study between propofol and etomidate in patients under general anesthesia. Braz J Anesthesiol 2016; 66(3): 237-41.
Journal of Isfahan Medical School
Volume 36, Issue 498 - Serial Number 498
September and October 2018
Pages 1175-1182

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History

  • Receive Date: 02 June 2018
  • Revise Date:
  • Accept Date: 06 April 2022

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