Division of Anesthesiology, Geneva University Hospitals, Geneva, Switzerland.
Anesthesiology. 2013 Aug;119(2):303-16. doi: 10.1097/ALN.0b013e31829aaff4.
Intraoperative high inspired oxygen fraction (FIO2) is thought to reduce the incidence of surgical site infection (SSI) and postoperative nausea and vomiting, and to promote postoperative atelectasis.
The authors searched for randomized trials (till September 2012) comparing intraoperative high with normal FIO2 in adults undergoing surgery with general anesthesia and reporting on SSI, nausea or vomiting, or pulmonary outcomes.
The authors included 22 trials (7,001 patients) published in 26 reports. High FIO2 ranged from 80 to 100% (median, 80%); normal FIO2 ranged from 30 to 40% (median, 30%). In nine trials (5,103 patients, most received prophylactic antibiotics), the incidence of SSI decreased from 14.1% with normal FIO2 to 11.4% with high FIO2; risk ratio, 0.77 (95% CI, 0.59-1.00). After colorectal surgery, the incidence of SSI decreased from 19.3 to 15.2%; risk ratio, 0.78 (95% CI, 0.60-1.02). In 11 trials (2,293 patients), the incidence of nausea decreased from 24.8% with normal FIO2 to 19.5% with high FIO2; risk ratio, 0.79 (95% CI, 0.66-0.93). In patients receiving inhalational anesthetics without prophylactic antiemetics, high FIO2 provided a significant protective effect against both nausea and vomiting. Nine trials (3,698 patients) reported on pulmonary outcomes. The risk of atelectasis was not increased with high FIO2.
Intraoperative high FIO2 further decreases the risk of SSI in surgical patients receiving prophylactic antibiotics, has a weak beneficial effect on nausea, and does not increase the risk of postoperative atelectasis.
术中高吸入氧分数（FIO2）被认为可以降低手术部位感染（SSI）和术后恶心呕吐的发生率，并促进术后肺不张。
作者检索了比较全麻手术中术中高 FIO2 与正常 FIO2 的随机试验（截至 2012 年 9 月），并报告 SSI、恶心或呕吐或肺部结果。
作者纳入了 22 项试验（7001 例患者），发表在 26 份报告中。高 FIO2 范围为 80%至 100%（中位数为 80%）；正常 FIO2 范围为 30%至 40%（中位数为 30%）。在 9 项试验（5103 例患者，大多数接受预防性抗生素）中，正常 FIO2 组 SSI 的发生率为 14.1%，高 FIO2 组为 11.4%；风险比为 0.77（95%可信区间，0.59-1.00）。结直肠手术后，SSI 的发生率从 19.3%降至 15.2%；风险比为 0.78（95%可信区间，0.60-1.02）。在 11 项试验（2293 例患者）中，正常 FIO2 组恶心的发生率为 24.8%，高 FIO2 组为 19.5%；风险比为 0.79（95%可信区间，0.66-0.93）。在未接受预防性止吐药的吸入麻醉患者中，高 FIO2 对恶心和呕吐均有显著的保护作用。9 项试验（3698 例患者）报告了肺部结果。高 FIO2 并未增加肺不张的风险。
在接受预防性抗生素的手术患者中，术中高 FIO2 进一步降低 SSI 的风险，对恶心有微弱的有益作用，且不会增加术后肺不张的风险。
