Nocturnal Hypoxemia After Lobectomy for Lung Cancer

Adding ketamine to morphine for patient-controlled analgesia after thoracic surgery: influence on morphine consumption, respiratory function, and nocturnal desaturation

“…26 After major abdominal surgery, 27 episodic arterial hypoxaemia could occur during the first postoperative nights resulting from the combination of alteration of pulmonary function and changes in sleep pattern with breathing disturbances. 28 Kawai and colleagues 15 have recently reported that the frequency of hypoxaemia after lung resection which was higher than in a gastrectomy control group. Similarly, our results showed a high incidence of nocturnal hypoxaemia in the first postoperative nights.…”

Nocturnal episodic hypoxemia after ambulatory breast cancer surgery: comparison of sevoflurane and propofol-fentanyl anesthesia

“…A number of reports have demonstrated that episodic nocturnal hypoxemia develops or is aggravated after open abdominal surgery [6,7,9,[13][14][15]17], abdominal vascular surgery [11,12,20], major orthopedic surgery [6,10,16,19], thoracotomy [21], cesarean section [8], laparoscopic surgery [18], and video-assisted thoracic surgery [21]. It is reported that no significant nocturnal hypoxemia episodes developed after ophthalmic (lens extraction) or middle ear surgery (tympanoplasty) under general anesthesia and suggested that general anesthesia alone or minimally invasive surgery itself is not a risk factor of postoperative nocturnal hypoxemia [13,15,24].…”

“…Sensor detached period and motion-induced errors were excluded from the analysis. Hypoxemia was defined as Sp O 2 <90% for >10 s, and desaturation as 5% or more reduction in Sp O 2 from baseline (the average of the highest 10 data points in the previous 5 min) for >10 s [18,20,21]. Desaturation is related to significant respiratory events (apneas and hypopneas), and hypoxemia, which is influenced by duration of desaturation episodes and baseline Sp O 2 , represents the severity of episodic hypoxemia [2,18,21,28].…”

“…Hypoxemia was defined as Sp O 2 <90% for >10 s, and desaturation as 5% or more reduction in Sp O 2 from baseline (the average of the highest 10 data points in the previous 5 min) for >10 s [18,20,21]. Desaturation is related to significant respiratory events (apneas and hypopneas), and hypoxemia, which is influenced by duration of desaturation episodes and baseline Sp O 2 , represents the severity of episodic hypoxemia [2,18,21,28]. Percentages of total recording time with effective recording (%time with effective recording), sensor detached (%time with sensor detached) and body movement (%time with body movement), and percentage of effective recording time with hypoxemia (%time with Sp O 2 <90) were calculated ( Fig.…”

“…In the early postoperative period, constant or episodic hypoxemia often occurs after major surgery; therefore, all patients should be monitored with hemoglobin oxygen (O 2 ) saturation and receive O 2 therapy after major surgery in a postanesthesia care unit (PACU) [1]. Several studies have documented episodic hypoxemia during the first to fifth nights after major surgery [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. It has been demonstrated that postoperative nocturnal hypoxemia may contribute to postoperative morbidity and mortality, such as impaired wound healing, wound infection, delirium, cerebral stroke, myocardial ischemia, infarction, and unexpected sudden death [2][3][4][5]13].…”