The Influence of Surgical Sites on Early Postoperative Hypoxemia in Adults Undergoing Elective Surgery

Abstract

We found that the severity of arterial desaturation and the incidence of hypoxemia during the early postoperative period are closely related to the surgical sites and are strongest for thoracoabdominal surgery, less for upper abdominal surgery, and least for peripheral surgery.

L’obésité, l’analgésie péridurale et l’incision sous-costale sont des facteurs de risque de désaturation postopératoire

“…Administration of oxygen is not standard treatment unless patients have pre-existing diseases or abnormal conditions. However, the incidence of postoperative hypoxemia reported in previous studies ranges from 30-50%, [8][9][10] with Upper midline ± lower midline incision 86 (50. the highest incidence of early hypoxemia occurring in the PACU, 17 and the incidence of late arterial hypoxemia peaks on the second postoperative day. 5,6 In this study, we used three definitions to determine desaturation.…”

“…Sample size calculation was based on an expected incidence of desaturation of 40% derived from a 30-50% incidence in previous studies. [8][9][10] To obtain a 95% confidence interval (CI) of 7%, a sample of 189 subjects was required. Regarding the secondary objective, it was anticipated that there would be seven factors associated with desaturation: age C 70 yr, obesity, heavy smoker, subcostal incision, neuraxial opioid for postoperative pain control, greater operative time, and intraoperative blood loss.…”

“…7 Therefore, the incidence of postoperative desaturation, which has been reported as 30-50% in the past, might be less today. [8][9][10] As a result, supplemental oxygen might be unnecessary on general surgical wards for selected patients who receive adequate postoperative pain control after upper abdominal procedures.…”

Kafkas Journal of Medical Sciences 2014; 4 (2): 45-86. Full Issue

“…NIV is not an old technique to treat or prevent these complications; it has become popular since 1990s. Many reviews actually suggest that patients with higher risks for postoperative respiratory failure; including the individuals who are obese or affected by lung diseases and those undergoing surgical procedures at higher risk of PPC, and patients undergoing cardiac, thoracic or upper abdominal surgery; would benefi t from NIV mostly [38][39][40] . Th e risk of PPC is highest in cardiac surgery, followed by thoracic and abdominal surgeries 19 Local tumor seeding of the nephrostomy tract has been theorized as a potential risk of percutaneous management of upper tract tumors and only a few cases of nephrostomy tract seeding have been reported 3 .…”

Comparison of epidural and single-shot paravertebral block analgesia after thoracotomy

“…Zaman içinde giderek azalan ve doku iyileşmesi ile sonlanan postoperatif ağrı çabuk ve etkin tedavi edilmelidir. ancak aksi takdirde pulmoner kompliyansta azalma, derin solunum ve güçlü öksürmede yetersizlik sonucu sekresyon birikimi ve atelektazi gibi önemli solunumsal komplikasyonlara neden olabilir [3] . Ayrıca ağrı, plazma katekolamin dü-zeyini normalin birkaç katına çıkararak sistemik vasküler direncin (SVR), kalp yükünün, miyokard oksijen tüketiminin artmasına, hipertansiyona, miyokard iskemisine ve kardiyak aritmilere, gastrointestinal motilitede ve splanknik dolaşımda azalmaya neden olarak özellikle ileri yaş ve iskemik kalp hastalığı varlığında morbidite ve mortalitede ciddi artışlara neden olabilir [4] .…”