Hypoxaemia during Postoperative Recovery using Continuous Pulse Oximetry

Abstract

Continuous pulse oximetry monitoring was used to determine the incidence of hypoxaemia (arterial oxygen saturation ≤ 90%) occurring in the first hour of postoperative recovery. Of 107 patients studied, hypoxaemia was recorded in 80%. Twenty-eight (26%) of these patients had saturations below 80%. The average frequency (i.e., the number of desaturations per patient) and the total duration of these desaturations was 7.7 desaturations and 182 seconds respectively. Intermittent measurements taken preoperatively and at 5 and 30 minutes postoperatively revealed hypoxaemia in 2%, 4% and 6% of patients respectively. In 39 patients who received oxygen therapy throughout the monitoring period, 64% experienced hypoxaemia within the first 15 minutes of recovery as opposed to only 18% in the final 15 minutes monitoring period. Of the factors assessed, only patients with a body mass index > 25 had an increased risk of hypoxaemia (P < 0.01). Four patients required active intervention and ventilatory assistance. We conclude that postoperative hypoxaemia is a particularly common occurrence even in patients otherwise considered healthy. Hence, pulse oximetry should be employed routinely during recovery. Where possible, monitoring should be performed continuously for at least 45 minutes.

Performance of three new-generation pulse oximeters during motion and low perfusion in volunteers

“…Earlier work showed that pulse oximeters failed in the operating room in 2.5% of 10,312 patients randomized to be monitored [8]. Pulse oximeter failure rates are even higher in critical care, intensive care, and Postanesthesia Care Unit (PACU) environments [9]. New-generation pulse oximeters are designed to overcome these limitations.…”

Effect of a Sub-Anaesthetic Concentration of Halothane on the Ventilatory Response to Sustained Hypoxia in Healthy Humans

“…This effect has important clinical consequences, as sub-anaesthetic concentrations are present after operation when patients are relatively unsupervised. Suppression of the hypoxic ventilatory response would therefore be hazardous in patients after operation, as large clinical studies have reported frequent hypoxaemia in recovery room patients [7,8].…”

Desflurane versus sevoflurane for laparoscopic gastroplasty in morbidly obese patients

“…Morbidly obese patients are at increased risk for complications from general anesthesia and surgery [1][2][3][4][5][6]. In comparing desflurane with sevoflurane in morbidly obese patients undergoing laparoscopic gastroplasty, recovery characteristics between the two agents were comparable.…”

“…Some of these risks include difficult tracheal intubation, aspiration, airway obstruction, atelectasis, decreased functional residual capacity, increased airway resistance, oxygen desaturation, and sleep apnea syndrome, which can further complicate postoperative respiratory recovery [1][2][3][4][5][6]. Even slight improvement in early or intermediate airway recovery would be beneficial because obese patients would be more apt to maintain higher oxygen saturation (Spo 2 ) after surgery and less likely to have cardiac and respiratory complications in the postoperative period.…”