Kabon Barbara, Kurz Andrea
Department of Anesthesiology and General Intensive Care, Vienna General Hospital, University of Vienna, Austria.
Curr Opin Anaesthesiol. 2006 Feb;19(1):11-8. doi: 10.1097/01.aco.0000192775.24774.15.
During anesthesia and surgery oxygen is routinely administered to all patients. Inspired oxygen concentrations, however, vary between 30 and 100%, and oxygen is often administered in a seemingly random manner. During the last decade it has been shown in several randomized trials that perioperative supplemental oxygen administration might improve outcome after certain surgical procedures. The purpose of this review is to provide an overview about the benefits and risks of supplemental oxygen administration in the perioperative period.
Supplemental oxygen improves immune function. Furthermore, 80% inspired oxygen fraction almost doubles subcutaneous tissue oxygen tension and halves the rate of postoperative wound infections. Some studies have shown that supplemental oxygen also decreases the rate of postoperative nausea and vomiting after laparoscopic and open abdominal surgical procedures. Preconditioning with oxygen might improve organ function after liver transplantation and outcome after spinal ischemic insults. Supplemental perioperative oxygen administration is not associated with clinically important side effects.
Supplemental oxygen administration during the perioperative period might be a simple, inexpensive and well-tolerated treatment option to improve patient outcome. The optimal inspired oxygen concentration still needs to be evaluated.
在麻醉和手术期间，通常会给所有患者常规吸氧。然而，吸入氧浓度在30%至100%之间变化，而且吸氧方式往往看似随意。在过去十年中，多项随机试验表明，围手术期补充吸氧可能会改善某些手术的术后结局。本综述的目的是概述围手术期补充吸氧的益处和风险。
补充吸氧可改善免疫功能。此外，80%的吸入氧分数几乎可使皮下组织氧张力加倍，并使术后伤口感染率减半。一些研究表明，补充吸氧还可降低腹腔镜和开放性腹部手术后的术后恶心呕吐发生率。氧预处理可能会改善肝移植后的器官功能以及脊髓缺血损伤后的结局。围手术期补充吸氧与临床上重要的副作用无关。
围手术期补充吸氧可能是一种简单、廉价且耐受性良好的改善患者结局的治疗选择。最佳吸入氧浓度仍有待评估。
