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British Journal of Anaesthesia, 1992, Vol. 69, No. 2 137-142
© 1992 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

RISK FACTORS FOR OXYGEN DESATURATION DURING SLEEP, AFTER ABDOMINAL SURGERY

L. BEYDON, M.D.*, J. HASSAPOPOULOS, M.D., M.-A. QUERA, M.D., A. RAUSS, M.D., J.-P. BECQUEMIN, M.D., F. BONNET, M.D., A. HARF, M.D. and F. GOLDENBERG, M.D.

Service d'Anesthesie-Reanimation, the Service des Explorations Fonctionnelies, the Service de Chirurgie Vasculaire and INSERM U296, Hdpital Henri Mondor 51 Avenue du Marechal de Lattre de Tassigny, 94010 Creteil, France

*Address for correspondence: Service d'Anesthisie-Reanimation, Hopital Henri Mondor, 94010 Cretéil, France.

The postoperative period after major abdominal surgery is known to be a period of increased episodic oxygen desaturation. In order to assess the risk factors for episodic desaturation, we have studied 29 surgical patients using pulse oximetry during the preoperative night (Npre when they received benzodiazepine premedication and breathed air, and also during the first three nights after operation when they received nasal oxygen supplementation. Modal oxygen saturation (Spo2 exceeded 95 % during all nights studied. The time spent at less than 90% (t90) and 85% (t85) Spo2 and the average Sp2,nadir did not differ each night. Heart rate was greater (mean 90.1 (SD 16.6) vs 65.2 (12.0) beat min–1, P < 0.007; during the second night after operation (N2) than during Npre. Before operation, the number of desaturations, t90 and t85 correlated with pharyngeal hypertrophy (P = 0.003, P = 0.002, P = 0.007, respectively). At the same time, t90 and X85 correlated with body mass index (P = 0.02 and P = 0.05, respectively). During N2, t90 correlated with radiological lung consolidation (P =0.05) and Spo2nadir correlated with FEV1, (P = 0.03). We conclude that there are several mechanisms responsible for oxygen de-saturation and that these mechanisms differ before and after surgery.


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