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The effect of oxygen reserve index guided oxygen titration on oxidative stress in rhinoplasty surgery: a randomized
Recep Karakaşoğlu1, Fatih Doğu Geyik2, Banu Eler Çevik2
1Department of Anesthesiology and Reanimation, Gaziantep City Hospital, Gaziantep, Türkiye. erecep_1992@hotmail.com.
Background:
The aim of this study is to evaluate whether the use of Oxygen Reserve Index (ORi) can prevent hyperoxia in patients undergoing rhinoplasty surgery and whether it can reduce oxidative stress caused by hyperoxia.
Methods:
A total of 60 patients, who were scheduled for rhinoplasty surgery and had an American Society of Anesthesiologists (ASA) score of I and II, were included in the study. The patients were randomly divided into two groups: the ORi group (Group R) and the control group (Group C). In Group R, oxygen support was titrated to keep the ORi values close to zero. In the control group, oxygen support was provided conventionally. Arterial blood gas samples were taken after intubation, at the 120th minute of the surgery and at the end of the surgery to record partial arterial oxygen pressure (PaO₂) values. During this process, patients' peripheral oxygen saturation (SpO₂) and ORi values were continuously recorded along with hemodynamic data. Preoperative and postoperative blood samples were collected from both groups, and oxidative stress was assessed by evaluating thiol-disulfide homeostasis and ischemia-modified albumin (IMA), which are current indicators of oxidative stress.
Results:
The demographic characteristics and the surgical durations were similar between the groups. PaO₂ values were lower in Group R compared to Group C. ORi values were correlated with PaO₂ values. Preoperative native thiol, total thiol, and disulfide values were similar in both groups. In both groups, postoperative native thiol, total thiol, and disulfide values decreased compared to the preoperative period, while IMA values increased. In Group R, the decrease in native thiol and total thiol values and the increase in IMA values were less than in Group C.
Conclusion:
We concluded that ORi guided oxygen titration may reduce the severity of hyperoxia and may decrease oxidative stress in rhinoplasty surgery.
Trial Registration:
ClinicalTrials.gov Identifier NCT07158073. Registered on 21 August 2025.
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