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Hypoxemia after General Anesthesia in Children

Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Abstract

Postoperative hypoxemia has been well documented in adults but not in infants and children, although they are potentially more susceptible to airway closure and to disturbances in pulmonary gas exchange. In a prospective study, we measured arterial oxygen saturation (SaO₂) with a pulse oximeter in 97 ASA class I infants and children breathing room air before and after general anesthesia for superficial surgical procedures. Mean preoperative SaO₂ was 97.6 ± 0.15% (SEM). On arrival in the recovery room after anesthesia mean SaO₂ in room air had decreased significantly (P < 0.01) to 93.0 ± 0.49% (range 100–71%), corresponding to calculated arterial oxygen tension (PaO₂) of about 66 mm Hg.

The second reading, 5–15 min later, also showed a statistically significant (P < 0.01) decrease in SaO₂ (94.1 ± 0.35%). There was no statistical difference in SaO₂ between patients who received inhalation anesthesia alone and those who were given narcotics. There was also no correlation between postoperative reduction in SaO₂ and duration of anesthesia or patient age. Of 67 patients who were asleep on arrival in the recovery room, 47 who remained asleep at the second SaO₂ reading had an average increase in SaO₂ of less than 1%. In contrast, in those patients who awoke, average SaO₂ increased more than 4% during a similar time period—a difference that was statistically significant (P < 0.02).

Key Words: ANESTHESIA—pediatric • HYPOXIA—postanesthetic • MONITORING—oxygen saturation

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999