Oxygen administration during general anaesthesia for surgery

Abstract

Oxygen is routinely administered to almost all patients undergoing general anaesthesia, 1 to ensure adequate oxygenation from intubation until awakening-the period when complications due to hypoxaemia are most likely to occur. 2 Currently, the optimal target for oxygen administration is not yet clear and varies from normal arterial oxygen saturation to hyperoxaemia (usually defined as >97-98% arterial oxygen saturation). The hyperoxaemia strategy has been widely used since a seminal study highlighted the benefits of liberal (80%) compared with restrictive (30-35%) inspired oxygen to reduce the risk of postoperative infection. 3 Accordingly, the 2016 World Health Organization guidelines recommend that patients receive a liberal fraction of inspired oxygen during general anaesthesia and in the immediate postoperative period. 4 5

Oxygen Variations—Insights into Hypoxia, Hyperoxia and Hyperbaric Hyperoxia—Is the Dose the Clue?

“…Nowadays, the therapeutic use of oxygen is not only limited to restoring hypoxia, but several newly developed approaches use oxygen not only as a "restoring agent" [2] but also as a potent stimulus [3]. Salvagno et al based their review on the paradoxical response of the intermittent shift between hyperoxic-normoxic exposure, which was shown to enhance erythropoietin production and raise hemoglobin levels with numerous different potential applications in many fields of therapy as a new strategy for surgical preconditioning aimed at frail patients and prevention of postoperative anemia.…”

Poor housing and dark satanic mills

“…A US study finds that supraphysiological levels of oxygen administration during surgery may lead to postoperative organ injury (doi:10.1136/bmj-2022-070941). 14 Oxygen can be a double edged sword, say editorialists Michele Samaja and Davide Chiumello (doi:10.1136/bmj.o2823),15 and the use of supraphysiological oxygen levels is something that anaesthetists and surgeons must now reconsider.…”