OXYGEN ADMINISTRATION DURING TRANSPORT AND RECOVERY AFTER OUTPATIENT SURGERY DOES NOT PREVENT EPISODIC ARTERIAL DESATURATION

Study Objective: To compare the efficacy of two different oxygen (O-2) delivery systems in preventing episodic arterial desaturation in the immediate postoperative period. Study Design: Randomized, prospective, nonblinded comparison in patients. Setting: Operating room and postan esthesia care unit (PACU) of a university outpatient surgery center. P atients: 100 ASA status I and II adults, male and female, age greater than 18 years, undergoing outpatient surgical procedures not involving the upper airway. Interventions: Group I received supplemental O-2 ad ministered by bag-valve-mask during transport, followed by 40% face sh ield in the PACU. Group 2 received supplemental O-2 by nasal cannula a t 4 L/min both during transport and during PACU stay. Measurements and Main Results: Arterial O-2 saturation (SpO(2)) was collected by compu ter from a recording pulse oximeter at 15-second intervals beginning b efore extubation and continuing until O-2 administration was discontin ued in PACU. Neither mode of therapy was successful in completely elim inating arterial desaturation defined as SpO(2) less than 90%, nor was there any difference in efficacy between the two treatment groups. Gr oup 1 had 8 patients desaturate on 9 different occasions (5 times duri ng transport, 4 times in PACU). Group 2 had 5 patients desaturate on 9 different occasions (4 times during transport, 5 times in PACU). Conc lusion: Routine O-2 administration during transport and PACU stay did not abolish episodic desaturation, even in healthy patients undergoing minor surgical procedures. Given the marked difference in acquisition costs, it would appear that O-2 administration by nasal cannula is a more cost-effective alternative for routine postoperative O-2 administ ration in certain groups undergoing anesthesia for outpatient surgery.