Prevention of Hypoxemia in Good-Risk Patients during Postoperative Transport by Positioning and Deep Breathing

Abstract

During recovery from general anesthesia, patients may develop arterial hypoxemia, and, therefore, some investigators have recommended that oxygen be administered routinely during transport from the operating room to the postanesthesia recovery room. We hypothesized that adequate oxygenation can be maintained in physically fit patients by positioning and deep breathing alone. Subjects and Method: We monitored the arterial oxygen saturation (SaO₂) of 60 physically fit surgical patients, prior to and during transport. Patients were randomly assigned to one of four groups prior to extubation and were then extubated, preoxygenated, positioned, and transported. Patients in Groups 1 and 2 were transported in a horizontal supine position, with Group-2 patients instructed to deep breathe every 10 to 15 seconds. Patients in Groups 3 and 4 were trans- ported in a semirecumbent position with the head elevated 40°, with Group-4 patients instructed to deep breathe every 10 to 15 seconds. SaO₂s were recorded for each patient at 0, 2, 4, 6, 8, and 10 minutes. Results: The Group-4 mean SaO₂ was significantly higher than those of the other groups. Conclusions: We believe that the higher mean SaO₂ was due to the augmented functional residual capacity and inspiratory capacity of the Group-4 patients. We conclude that good- risk patients can be safely transported without supplemental oxygen when the described measures to increase lung volumes are provided and no specific contraindications exist.