The incidence of early post-operative hypoxemia and its contributing factors among patients underwent operation under anesthesia at University of Gondar comprehensive and specialized referral hospital, Gondar, North West Ethiopia, 2018. A prospective observational study

Abstract

Background: Hypoxemia is defined as low level of oxygen in the blood. The early postoperative period is a critical time for developing hypoxemia. It is well known that the physiological response of the patient is not reversed immediately after anesthesia and surgery. Supplemental oxygen should be considered in patients who had operation under anesthesia at the potential time of post-operative period. Objective: The objective of this study was to determine the incidence of early post-operative hypoxemia and its contributing factors among operated patients under anesthesia during transportation to recovery rooms and at recovery rooms. Methods: A prospective observational study design was conducted to determine the incidence of early post-operative hypoxemia and to identify the contributing factors among operated patients who had undergone with anesthesia from March 1 to April 10, 2018. Data were checked on daily basis. Data were entered to Epi Info and analyzed by statistical package for social sciences (SPSS) version 20 software. Descriptive statistics were used to summarize patient's sociodemographic data. Bivariate and multivariate binary logistic regressions were conducted to see the existence of the association between dependent and independent variables. Results: 424 operated patients were included. The overall incidence of early post-operative hypoxemia among the study subjects (424) was 113 (26.7%). The risk factors of early post-operative hypoxemia were preoperative oxygen saturation <95%, general anesthesia, heart disease, subcostal incision, surgical duration ≥120 min, muscular strength score 0 and hepato-biliary-pancreas surgeries. Conclusion: The incidence of early postoperative hypoxemia was high and risk factors of early post-operative hypoxemia were preoperative oxygen saturation<95%, general anesthesia, heart disease, subcostal incision, surgical duration >120 min, muscular strength score 0 and hepato-biliary-pancreas surgeries. Therefore, oxygen administration should be commenced to all risky patients for hypoxemia during early post-operative period. Highlights:

Predictors of hypoxemia after general anesthesia in the early postoperative period in a hospital in Ethiopia: An observational study

“…In this study, we identified that patients with a BMI >25 kg/m2, having a chronic disease (hypertension and bronchial asthma), current smokers, with lower oxygen saturation before induction (SpO 2 <95%), emergency surgery, and the absence of oxygen therapy during the period of transfer of the patient from operation theatre and/or in the PACU were all significantly associated with increased hypoxemia in the early postoperative period. This finding was similar to various studies, which showed that patients who had respiratory co-morbidity [ 25 , 26 ] and were smokers [ 20 , 23 , 26 ], patients who were obese [ 23 , 26 ], withlower preoperative oxygen saturation (SPO 2 < 95%) [ 7 , 20 , 24 ,] were significantly associated with increased hypoxemia.…”

“…This discrepancy might be due to a variation in study settings where the above developed countries could have a better perioperative patient care as compared to the developing ones like Ethiopia. The incidence of hypoxemia in studies done in Ethiopia was 22.7% [ 25 ] and 26.7% [ 20 ] in Tikur Anbesa Comprehensive Specialized hospital and in University of Gondar hospital, respectively. In this study, we identified that patients with a BMI >25 kg/m2, having a chronic disease (hypertension and bronchial asthma), current smokers, with lower oxygen saturation before induction (SpO 2 <95%), emergency surgery, and the absence of oxygen therapy during the period of transfer of the patient from operation theatre and/or in the PACU were all significantly associated with increased hypoxemia in the early postoperative period.…”

“…As patient returned to the recovery room, the arterial oxygen, saturation level was measured immediately with pulse oximetry then every 5 min till 20 min. A questionnaire was developed from different bibliographic research [ 2 , 20 , 21 ], which includes demographic and patient-related data, surgery-related data, and anesthetic-related data. Demographic and patient-related characteristics: age, sex, ASA, BMI, smoking status, history of the medical disease; surgery-related characteristics: Type of surgery, the urgency of the procedure, positioning, the estimated blood loss, necessity of blood transfusion; anesthetic-related characteristics: premedication, SPO 2 reading before induction, IV induction agent, muscle relaxant, use of reversal (neostigmine), analgesics used, the total amount of intraoperative fluid, time from intubation to extubation, oxygen therapy during patient transfer and/or PACU, and sedation score.…”

Magnitude Of Early Postoperative Hypoxemia And Its Associated Factors Among Adult Patients Who Undergo Emergency Surgery Under General Anesthesia At Jimma Medical Center, Jimma, Southwest Ethiopia, 2021. A Prospective Observational Study

“…This nding was high compared with previous study conducted at Gondar (26.7%). (20) This high differences may be attributed to, due only emergency surgery, emergency surgery under general anesthesia with ETT and the cutoff point of SpO2 less than or equal to 92 were used in this study. Moreover, the current incidence was also high as compared with the study conducted in Canada(20%).…”

“…The result was in agreement with studies done in Qatar, Brazil and Ethiopia. (9,20,24) The amenable explanation may be due to the fact that muscular strength zero indicates as there is residual neuromuscular blockade which impair the muscles of respiratory system. (25) Likewise, the current study vividly delineated that age greater than 55 had a signi cant association with EPH.…”