Optimal perioperative oxygen administration

During anesthesia and surgery oxygen is routinely administered to all patients. Inspired oxygen concentrations, however, vary between 30 and 100%, and oxygen is often administered in a seemingly random manner. During the last decade it has been shown in several randomized trials that perioperative supplemental oxygen administration might improve outcome after certain surgical procedures. The purpose of this review is to provide an overview about the benefits and risks of supplemental oxygen administration in the perioperative period.

Supplemental oxygen improves immune function. Furthermore, 80% inspired oxygen fraction almost doubles subcutaneous tissue oxygen tension and halves the rate of postoperative wound infections. Some studies have shown that supplemental oxygen also decreases the rate of postoperative nausea and vomiting after laparoscopic and open abdominal surgical procedures. Preconditioning with oxygen might improve organ function after liver transplantation and outcome after spinal ischemic insults. Supplemental perioperative oxygen administration is not associated with clinically important side effects.

Supplemental oxygen administration during the perioperative period might be a simple, inexpensive and well-tolerated treatment option to improve patient outcome. The optimal inspired oxygen concentration still needs to be evaluated.