Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942006000400003
Brazilian Journal of Anesthesiology
Scientific Article

Transporte de pacientes sem oxigenoterapia para a sala de recuperação pós-anestésica: repercussões na saturação de oxigênio e fatores de risco associados à hipoxemia

Transportation of patients to the post-anesthetic recovery room without supplemental oxygen: repercutions on oxygen saturation and risk factors associated with hypoxemia

Giancarlo Marcondes; Fábio Scalet Soeiro; Eduardo de Abreu Ferreira; Artur Udelsmann

http://dx.doi.org/10.1590/S0034-70942006000400003 Braz J Anesthesiol, vol.56, n4, p.352-361, 2006
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Resumo

JUSTIFICATIVA E OBJETIVOS: O transporte de pacientes da sala de cirurgia para a sala de recuperação pós-anestésica sem o uso de oxigenoterapia suplementar é prática comum, sendo utilizada apenas em pacientes de alto risco para o desenvolvimento de hipoxemia. O objetivo deste estudo foi avaliar a incidência das alterações na saturação de oxigênio durante esse transporte e identificar os fatores de riscos associados ao desenvolvimento de hipoxemia. MÉTODO: Avaliou-se uma amostra de 882 pacientes de ambos os sexos, estado físico ASA I, II e III, submetidos a intervenções cirúrgicas eletivas de várias especialidades e sob quatro técnicas anestésicas. A variável de saturação de oxigênio foi medida e registrada imediatamente antes da saída da sala de cirurgia e, de novo, na admissão na sala de recuperação pós-anestésica. RESULTADOS: Houve maior incidência de hipoxemia moderada/intensa durante o transporte de pacientes do sexo feminino (14,47%), nos pacientes estado físico ASA II e III (14,74% e 16,46%, respectivamente) e naqueles submetidos a cirurgias cardiotorácicas (28,21%), gastroproctológicas (14,18%) e de cabeça-pescoço (18,18%). A anestesia geral, entre as técnicas anestésicas empregadas, foi fator de risco associado ao desenvolvimento de hipoxemia. CONCLUSÕES: Existem fatores associados à ocorrência de hipoxemia durante o transporte da sala de cirurgia até a sala de recuperação pós-anestésica. A utilização seletiva de oxigenoterapia deve ser orientada pela presença desses fatores de risco, ou pelo uso do oxímetro de pulso, com o intuito de diminuir a morbimortalidade e a incidência de hipoxemia no pós-operatório imediato.

Palavras-chave

COMPLICAÇÕES, MONITORIZAÇÃO, RECUPERAÇÃO PÓS-ANESTÉSICA

Abstract

BACKGROUND AND OBJECTIVES: The transportation of patients from the operating room to the post-anesthetic recovery room without supplemental oxygen is a common practice, since oxygen supplementation is used only in patients at high risk of developing hypoxemia. The objective of this study was to evaluate the incidence of changes in oxygen saturation during this transportation and to identify the risk factors associated to the development of hypoxemia. METHODS: A cohort of 882 patients of both genders, physical status ASA I, II, and III, who underwent elective surgeries of several subspecialties using four different anesthetic techniques, was evaluated. Oxygen saturation was measured and recorded just before the patients left the operating room and as soon as they arrived in the recovery room. RESULTS: There was a greater incidence of moderate to severe hypoxia during the transport of female patients (14.47%), patients with physical status ASA II and III (14.74% and 16.46%, respectively), and those who underwent cardiothoracic (28.21%), gastroproctologic (14.18%), and head and neck (18.18%) surgeries. Among the anesthetic techniques used, general anesthesia was a risk factor associated with the development of hypoxia. CONCLUSIONS: There are factors associated with the development of hypoxia during the transportation of patients from the operating room to the post-anesthetic recovery room. The selective use of supplemental oxygen should be guided by the presence of those risk factors or by the use of a pulse oxymeter, in order to reduce the morbidity, mortality, and the incidence of hypoxemia early in the post-operatory period.

Keywords

COMPLICATIONS, MONITORIZATION, POST-ANESTHETIC RECOVERY

References

Watson CB. Respiratory complications associated with anesthesia. Anesthesiol Clin North America. 2002;20:513-537.

Oliveira Filho GR, Garcia JHS, Ghellar MR. Fatores associados com a ocorrência de hipoxemia no período pós-anestésico imediato. Rev Bras Anestesiol. 2001;51:185-195.

Lovell MA, Mudaliar MY, Klineberg PL. Intrahospitalar transport of critically ill patients: complications and difficulties. Anaesth Intensive Care. 2001;29:400-405.

Rock P, Rich PB. Postoperative pulmonary complications. Curr Opin Anaesthesiol. 2003;16:123-132.

Gift AG, Stanik J, Karpenick J. Oxygen saturation in postoperative patients at low risk for hypoxemia: is oxygen therapy needed?. Anesth Analg. 1995;80:368-372.

Greif R, Laciny S, Rapf B. Supplemental oxygen reduces the incidence of postoperative nausea and vomiting. Anesthesiology. 1999;91:1246-1252.

Fortis EAF, Nora FS. Hipoxemia e hipóxia perioperatória: conceito, diagnóstico, mecanismos, causas e fluxograma de atendimento. Rev Bras Anestesiol. 2000;50:317-329.

Nora FS, Fortis EAF. Influência dos fármacos utilizados na sedação, na indução e manutenção quanto a recuperação da anestesia. Rev Bras Anestesiol. 2000;50:141-148.

Xue FS, Li BW, Zhang GS. The influence of surgical sites on early postoperative hypoxemia in adults undergoing elective surgery. Anesth Analg. 1999;88:213-219.

Xue FS, Huang YG, Tong SY. A comparative study of early postoperative hypoxemia in infants, children and adults undergoing elective plastic surgery. Anesth Analg. 1996;83:709-715.

Braz JRC. Monitorização da oxigenação e da ventilação. Rev Bras Anestesiol. 1996;46:223-240.

Pedersen T, Dyrlund Pedersen B, Moller AM. Pulse oximetry for perioperative monitoring. Cochrane Database Syst Rev. 2003:CD002013.

Grass JA. The role of epidural anesthesia and analgesia in postoperative outcome. Anesthesiol Clin North Am. 2000;18:407-428.

Arozullah AM, Daley J, Henderson WG. Multifatorial risk index for predicting postoperative respiratory failure in men after major noncardiac surgery: The National Veterans Administration Surgical Quality Improvement Program. Ann Surg. 2000;232:242-253.

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