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AMBULATORY ANESTHESIA

Nocturnal Arterial Oxygen Desaturation and Episodic Airway Obstruction After Ambulatory Surgery

Departments of Anesthesiology and Pharmaceutics, University of Washington, Seattle, Washington

Address correspondence to T. Andrew Bowdle, MD, PhD, Department of Anesthesiology, Box 356540, Room AA117C, University of Washington, Seattle, WA 98195. Address e-mail to bowdle{at}u.washington.edu Reprints will not be available from the author.

Some patients experience disordered breathing during sleep and arterial oxygen desaturation after major inpatient surgery. We performed this study to determine whether similar events occur after ambulatory surgery. Forty-five ambulatory surgery patients received an unrestricted anesthetic. Continuous unattended nocturnal recordings of breathing pattern and oxygen saturation were made in the patients’ homes before surgery and during the first and second postoperative nights. Nine patients had a respiratory disturbance index >10 and/or >1% of recording time with oxygen saturation <90% on at least one study night. These nine patients had a significantly older median age and a significantly larger median body mass index. Their median respiratory disturbance index and median percentage of time with oxygen saturation <90% were significantly higher on the first postoperative night than on the preoperative night.

IMPLICATIONS: We studied nocturnal breathing before and after ambulatory surgery in 45 patients without a history of the sleep apnea syndrome. Nine patients had abnormal breathing that frequently resulted in hypoxemia. Oxygen desaturation occurred in the presence and absence of obvious upper airway obstruction. Five of the nine abnormally breathing patients had abnormal breathing before and after surgery.

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