J Med Assoc Thai 2008; 91 (7):1020

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Perioperative Desaturation and Risk Factors in General Anesthesia
Uakritdathikarn T Mail, Chongsuvivatwong V , Frederick A , Vasinanukorn M , Thinchana S , Klayna S

Objective: Despite advances in anesthetic technique, the incidence of perioperative desaturation in general
anesthesia has remained high. Knowledge on factors associated with intraoperative desaturation is relatively
scanty. The purpose of the present study was to investigate the distribution of time dependent intraoperative
desaturation and factors predicting perioperative desaturation.

Material and Method: A prospective observational analytic study was conducted. One thousand and ninety
three patients schedule for elective surgery under general anesthesia (GA) were enrolled. Exclusion criteria
were patients with preoperative arterial oxygen saturation (SpO2 ) < 95%, pregnant women, obvious difficult
airway, and those requiring mechanical ventilation postoperatively. Desaturation was defined as oxygen
saturation < 95% for > 10 seconds.

Results: Among 1093 eligible cases, 30 cases (2.74%) developed intraoperative desaturation. The probability of
desaturation during induction, maintenance, and emergence were 0.55% (6/1093), 2.01% (22/1093), and
0.18% (2/1093), respectively. Occurrences of desaturation at the recovery room (RR) were noted in 224
patients (20.49%). Younger, obese patients, snorers, and lower respiratory tract infection were significant
high-risk groups of intraoperative desaturation. Elderly, obese patients, snorers, positive history of pulmonary
disease, modified Aldrete’s score < 8, and duration of GA > 180 minutes predicted desaturation at RR.

Conclusion: Obesity and snorers were the high-risk groups of perioperative desaturation. Elderly patients
are at lower risk of desaturation than children intraoperatively, but at a higher risk in the postoperative
period. Higher FiO2 should be given to high-risk patients during the intraoperative period. Desaturation can
still occur at RR, even in patients who received oxygen. Pulse oximeter monitoring should be continued
throughout RR care.

Keywords: Desaturation, General anesthesia, Perioperative, Risk factor, Recovery room

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