Oxygen administration during transport and recovery after outpatient surgery does not prevent episodic arterial desaturation

• Published in: Journal of clinical anesthesia 1996-06, Vol.8 (4), p.294-300
• Main Authors: Scuderi, Phillip E., Mims, Grover R., Weeks, Duke B., Harris, Lynette C., Lipscomb, Laurie, James, Robert L.
• Format: Article
• Language: English
• Subjects: Adult; Ambulatory anesthesia; Ambulatory Surgical Procedures; Blood Gas Monitoring, Transcutaneous; Female; Heart Rate; Humans; Male; Middle Aged; outpatient surgery; Oxygen - blood; Oxygen Inhalation Therapy - instrumentation; Oxygen Inhalation Therapy - methods; oxygen therapy, postanesthesia care unit, pulse oximetry; Postanesthesia Nursing; Postoperative Period; Recovery Room; Regression Analysis; Transportation of Patients
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/0952-8180(96)00038-4

Study Objective: To compare the efficacy of two different oxygen (O 2) delivery systems in preventing episodic arterial desaturation in the immediate postoperative period. Study Design: Randomized, prospective, nonblinded comparison in patients. Setting: Operating room and postanesthesia care unit (PACU) of a university outpatient surgery center. Patients: 100 ASA status I and II adults, male and female, age greater than 18 years, undergoing outpatient surgical procedures not involving the upper airway. Interventions: Group I received supplemental O 2 administered by bag-valve-mask during transport, followed by 40% face shield in the PACU. Group 2 received supplemental O 2 by nasal cannula at 4 L/min both during transport and during PACU stay. Measurements and Main Results: Arterial O 2 saturation (SpO 2) was collected by computer from a recording pulse oximeter at 15-second intervals beginning before extubation and continuing until O 2 administration was discontinued in PACU. Neither mode of therapy was successful in completely eliminating arterial desaturation defined as SpO 2 less than 90%, nor was there any difference in efficacy between the two treatment groups. Group 1 had 8 patients desaturate on 9 different occasions (5 times during transport, 4 times in PACU). Group 2 had 5 patients desaturate on 9 different occasions (4 times during transport, 5 times in PACU). Conclusion: Routine O 2 administration during transport and PACU stay did not abolish episodic desaturation, even in healthy patients undergoing minor surgical procedures. Given the marked difference in acquisition cost, it would appear that O 2 administration by nasal cannula is a more cost-effective alternative for routine postoperative O 2 administration in certain groups of patients undergoing general anesthesia for outpatient surgery.