Supplemental Oxygen After Ambulatory Surgical Procedures

Comment This simple but well executed clinical study clearly shows that healthy women having uncomplicated outpatient gynecologic surgery can develop significant but nonclinically detectable hemoglobin desaturation when allowed to recover from general anesthesia breathing room air. By statistics the only significant factor favoring desaturation was age. Yet, the we of an endotracheal tube [10/104 (9.67c) in tuba ted desaturated versus 2/60 3.3% not intubated de-saturated; P = 0.14] and smoking (9 pack years in desaturated group versus 2 pack years in nonde-saturated; median value, P < 0.08) come close to statistical significance and with larger number may well have reached statistical significance. The duration of general anesthesia might also show significance in a larger series. The surgery performed was described simply as mostly gynecologic. Were there significant numbers of lapa-roscopic procedures where the abdomen was inflated with carbon dioxide which is irritating? One certainly could hypothesize an increased propensity toward desaturation during recovery after such procedures. Despite the limitations and unanswered questions of this study, we strongly support the authors' conclusions based on their data which is, “Because modest increases in inspired oxygen concentration are considered safe and were effective, we conclude that supplemental oxygen should be given to all ambulatory patients recovering from general anesthesia.” The prophylactic administration of oxygen until the patient is awake and moved from the stretcher to a chair is simple and effective, causes little patient discomfort, and represents minimal additional expense. Brett B. Gutsche, M.D. Theodore G. Cheek, M.D.