Patient transportation to post-anesthetic recovery area without supplemental oxygen: repercussions on oxygen saturation and risk factors associated with hypoxemia

ABSTRACT

Development of hypoxemia in the immediate postoperative period is a common event, even in healthy patients. In spite of what is known, it is a common practice to transport the patient to recovery room without adequate monitoring or administration of supplemental oxygen. To implement preventive measures to decrease the morbidity and mortality associated with this transportation, it is important to be aware of risk factors associated with the increased incidence of this complication. The aim of this work was to evaluate the incidence of changes in oxygen saturation and their relation to some associated risk factors during transportation of patients to recovery room without supplemental oxygen. The present study was performed on 970 patients undergoing elective surgeries. Four different anesthetic techniques were used; general anesthesia, general anesthesia with epidural analgesia, regional anesthesia with sedation and regional anesthesia without sedation. All patients were transported to the recovery area without supplemental oxygen and the peripheral oxygen was measured with a pulse oxymeter just before leaving the operating room. The incidence of mild hypoxemia was 27.7% while that of moderate/ severe hypoxemia was 12.1% of the studied patients. Significant reduction in peripheral oxygen was found in ASA II and III patients [p=0.001], in patients who received general anesthesia [p=0.001], in smokers [p=0.001], and in obese patients [p<0.001]. The incidence of mild hypoxemia was more among males, while incidence of moderate/ severe hypoxemia was more among females. No significant differences were found among different age groups or with different durations of surgery. It was concluded that it is necessary to monitor pulse oxymetry for all patients in the immediate postoperative period and patients with a high risk of developing postoperative hypoxemia must be transported with supplemental oxygen