British Journal of Anaesthesia, Vol 80, Issue 5 602-605, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
S. Isono, M. Sha, M. Suzukawa, Y. Sho, A. Ohmura, Y. Kudo, K. Misawa, S. Inaba and T. Nishino
Severe postoperative hypoxaemia during sleep may increase the risk of
postoperative cardiovascular complications. We hypothesized that the
severity of hypoxic episodes after surgery are related to the presence of
preoperative sleep-disordered breathing (SDB). We tested this hypothesis in
a multicentre study designed to elucidate the major risk factors for
development of postoperative nocturnal desaturations. We performed
overnight oximetry before operation and for one night between the second
and fourth day after operation in 80 patients undergoing major surgery. We
calculated oximetry variables such as oxygen desaturation index (ODI),
defined as the number of oxygen desaturations exceeding 4% below baseline,
percentage time spent at SpO2 < 90% (CT90, %) and lowest SpO2 value.
After operation, although the change in ODI was not significant (P = 0.34),
deterioration in CT90 and lowest SpO2 values were significant (P = 0.036
and P = 0.007, respectively). Multivariate analysis of possible risk
factors for postoperative desaturations revealed that preoperative
hypoxaemia and apnoea witnessed by others were highly correlated with
postoperative hypoxaemia.
CLINICAL INVESTIGATIONS
Preoperative nocturnal desaturations as a risk factor for late postoperative nocturnal desaturations
Department of Anaesthesiology, Chiba University School of Medicine, Chiba, Japan; Department of Anaesthesiology, Teikyo University, Tokyo, Japan; Department of Emergency and Critical Care Medicine, Jichi Medical College, Tochigi, Japan
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