Postoperative Oxygen Desaturation Following Spinal Anesthesia

摘要

The purpose of this study was to determine if operative oxygen desaturation occurs during transport from the operating room to the postanesthesia care unit in ASA 1 and 2 lower extremity orthopedic spinal anesthesia patients who received sedation with intravenous midazolam. Spinal anesthesia is considered a safe and effective alternative to general anesthesia. However, when spinal anesthesia is combined with intravenous sedation, patients may experience transitory respiration depression or even death. Spinal anesthesia patients are transported by anesthesia care providers from the operating room to the post anesthesia care unit without oxygen or oximetry monitors. This practice posed questions regarding patient safety during a critical postoperative period. While oxygen desaturation has been found to occur during transport in general anesthesia patients, it has not been studied in spinal anesthesia patients. Clear transport guidelines were not available from professional or regulatory sources. This study was conducted at a military community hospital in the central United States. A nonprobability, convenience sample was selected from patients presenting for lower extremity orthopedic surgical procedures in which subarachniod blockade was appropriate. A data collection tool was used to collect the following information: demographics, preoperative oxygen saturation (SpO2) and baseline vital signs; subarachnoid block medications, dose, and patient position during insertion; dermatome level of analgesia prior to removal of supplemental oxygen; patient temperature prior to transport; SpO2 prior to removal of supplemental oxygen; total surgery time; total dose of midazolam administered; length of time from dose of midazolam; lowest SpO2 during transport from the operating room to the post anesthesia care unit; and total transport time. Out study found no incidence of hypoxemia (Spo2 < 90%) in this patient sample.