Brown L T, Purcell G J, Traugott F M
Department of Anaesthesia, Royal North Shore Hospital, Sydney, NSW, Australia.
Anaesth Intensive Care. 1990 Nov;18(4):509-16. doi: 10.1177/0310057X9001800417.
Continuous pulse oximetry monitoring was used to determine the incidence of hypoxaemia (arterial oxygen saturation less than or equal to 90%) occurring in the first hour of postoperative recovery. Of 107 patients studied, hypoxaemia was recorded in 80%. Twenty-eight (26%) of these patients had saturations below 80%. The average frequency (i.e., the number of desaturations per patient) and the total duration of these desaturations was 7.7 desaturations and 182 seconds respectively. Intermittent measurements taken preoperatively and at 5 and 30 minutes postoperatively revealed hypoxaemia in 2%, 4% and 6% of patients respectively. In 39 patients who received oxygen therapy throughout the monitoring period, 64% experienced hypoxaemia within the first 15 minutes of recovery as opposed to only 18% in the final 15 minutes monitoring period. Of the factors assessed, only patients with a body mass index greater than 25 had an increased risk of hypoxaemia (P less than 0.01). Four patients required active intervention and ventilatory assistance. We conclude that postoperative hypoxaemia is a particularly common occurrence even in patients otherwise considered healthy. Hence, pulse oximetry should be employed routinely during recovery. Where possible, monitoring should be performed continuously for at least 45 minutes.
采用连续脉搏血氧饱和度监测来确定术后恢复第一小时内发生低氧血症(动脉血氧饱和度小于或等于90%)的发生率。在107例研究患者中,80%记录到低氧血症。其中28例(26%)患者的饱和度低于80%。这些低氧血症事件的平均发生频率(即每位患者的低氧血症发作次数)和总持续时间分别为7.7次和182秒。术前以及术后5分钟和30分钟进行的间歇性测量显示,低氧血症的发生率分别为2%、4%和6%。在整个监测期间接受氧疗的39例患者中,64%在恢复的前15分钟内出现低氧血症,而在最后15分钟监测期内这一比例仅为18%。在评估的因素中,只有体重指数大于25的患者发生低氧血症的风险增加(P<0.01)。4例患者需要积极干预和通气支持。我们得出结论,即使在其他方面被认为健康的患者中,术后低氧血症也特别常见。因此,在恢复期间应常规使用脉搏血氧饱和度监测。只要有可能,监测应持续至少45分钟。