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Arterial desaturation in healthy children during and after minor surgery
S Walther-Larsen1, M Sloth, N Valentin
1Department of Anesthesiology, Gentofte Hospital, Hellerup, Denmark.
Insights
Pulse oximetry (PO) monitoring can reveal undiagnosed desaturation in healthy children during and after minor surgeries. Widespread PO use may improve patient safety by detecting these events earlier.
Area of Science:
- Pediatric Anesthesiology
- Cardiopulmonary Monitoring
Background:
- Pulse oximetry (PO) is a key monitoring tool in anesthesia.
- Its utility in detecting subclinical desaturation in pediatric patients undergoing minor procedures requires further investigation.
Purpose of the Study:
- To assess the incidence of clinically undiagnosed desaturation in healthy children during and after minor ENT surgery under general anesthesia.
- To identify factors associated with desaturation events.
Main Methods:
- Pulse oximetry was applied to 79 healthy children during and after minor ENT surgery.
- PO data were only available to anesthesiologists if desaturation (SpO2 ≤ 85% for ≥ 30 s) occurred.
- Clinical diagnosis of desaturation was compared with PO-detected events.
Main Results:
- Clinically undiagnosed desaturation occurred in 12 cases during anesthesia and 9 during recovery.
- Adenoidectomy was associated with higher desaturation rates.
- Younger children and those resisting induction had lower SpO2 values.
Conclusions:
- Subclinical desaturation is common in healthy children during and after minor ENT procedures.
- Current clinical detection misses a significant number of desaturation events.
- Wider use of pulse oximetry during and after anesthesia may be advisable for improved patient safety.
Abstract:
Pulse oximetry (PO) was applied to 79 otherwise healthy children during and after minor ENT surgery under general anaesthesia in private practice. The PO data were not available to the anaesthetist unless desaturation to less than or equal to 85% was present for greater than or equal to 30 s. This occurred in 12 and 9 cases during anaesthesia and recovery, respectively, only 8 and 5 cases, respectively, being diagnosed clinically. Desaturation during and after anaesthesia was more common in children undergoing adenoidectomy than during procedures for which endotracheal intubation was not performed. During recovery, desaturation was more likely to occur in the same patients again. Lower values of SaO2 were found in younger children and in children resisting or crying at induction. There was a (weak) negative correlation between SaO2 and HR. As clinically undiagnosed desaturation occurs even in healthy children undergoing minor surgical procedures, a more widespread use of PO during and after anaesthesia may be advisable.