Oximetry Monitoring After Abdominal Surgery

Paul Curry, M.D., and Cheryl M. Hanna, R.N., department of anesthesiology, Hoag Memorial Hospital Presbyterian, Newport Beach (CA, USA). The study examined the incidence of hypoxemia for midline abdominal surgery patients who received neuraxial or PCA (patient-controlled) narcotic analgesia during the postoperative period on the general care floor. The researchers conducted their study using central pulse oximetry monitoring systems, including the Oxinet(R) II Central Station Network of Nellcor (Pleasanton, CA, USA).

"The incidence of postoperative hypoxemia is extraordinarily high in major abdominal surgery patients, but it's not easy to predict which patients will experience a hypoxemic event. Therefore, in my opinion, the patients who will benefit most from this technology are those at risk for preexisting oxygen supply-demand impairment, like that found in patients with coronary heart disease,” said Dr. Curry.

Using central pulse oximetry monitoring, the researchers found that the true incidence and severity of postoperative hypoxemia (SpO 2 < 90%) was extremely high in these abdominal surgery patients treated with either neuraxial or PCA narcotic analgesia and no significant differences were found between the two. The hypoxemic episodes tracked by the central pulse oximetry systems exceeded those documented on patient charts by more than 100-fold. This high incidence of hypoxemia occurred independent of common clinical characteristics associated with its risk, making prioritization of patients for monitoring unpredictable and difficult. Indeed, the ASA Physical Status (PS) stratification system was not shown to be significantly correlated with hypoxemia incidence in this study. Based on these findings, researchers concluded that major abdominal surgery patients receiving either neuraxial or PCA narcotic analgesia require a higher level of respiratory monitoring.




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