Oxygen saturation in children in the postoperative period
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D C Tyler1, M Woodham, J Stocks
1Department of Anesthesiology, Children's Hospital and Medical Center, Seattle, WA 98105.
Insights
Children undergoing surgery and receiving opioid pain management generally do not experience significant overnight oxygen desaturation. Postoperative oxygen saturation levels in pediatric patients remained stable, contrary to some adult findings.
Area of Science:
- Pediatric Anesthesiology
- Postoperative Care
- Respiratory Monitoring
Background:
- Adults may experience significant postoperative oxygen desaturation.
- Limited data exists on pediatric postoperative oxygen saturation, especially overnight.
- Children often undergo surgery with moderate to severe pain requiring opioid analgesia.
Purpose of the Study:
- To determine if children experience significant overnight oxygen desaturation post-surgery.
- To compare preoperative and postoperative overnight oxygen saturation in pediatric patients.
- To assess the impact of opioid pain management on pediatric postoperative oxygenation.
Main Methods:
- Overnight monitoring of oxygen saturation in 19 children (preoperative and postoperative).
- Overnight monitoring of oxygen saturation in 50 additional children (postoperative only).
- Patients received epidural, intravenous, or intramuscular opioids for pain management.
Main Results:
- No significant difference in mean oxygen saturation between preoperative and postoperative periods (96.6% vs 95.7%).
- No significant difference in time spent below key oxygen saturation thresholds (95%, 90%, 85%, 80%).
- Postoperative mean oxygen saturation in the second group was high (97.8%).
Conclusions:
- Pediatric patients receiving opioid analgesia after surgery did not exhibit significant overnight oxygen desaturation.
- Findings contrast with some reports in adult populations.
- Overnight oxygen saturation appears stable in children post-painful surgery.
Abstract:
Some adult patients have periods of significant oxygen desaturation after surgery but, other than for immediately after surgery in the recovery room, few data are available in children. We monitored overnight paired preoperative and postoperative oxygen saturations in 19 children, and overnight postoperative saturations in 50 additional children to determine whether children have periods of desaturation in the postoperative period. The children underwent surgery usually associated with moderate to severe postoperative pain, and were treated with epidural, intravenous, or intramuscular opioids. In the group of 19 children mean (SD) preoperative oxygen saturation was 96.6% +/- 1.3%, and the mean postoperative saturation was 95.7% +/- 1.2%. The average change was 0.88% +/- 1.52%. The 95% confidence interval of the paired difference was 0.13% to 1.6%. There was no significant difference in the percent of monitored time that the patients spent with an oxygen saturation less than 95%, 90%, 85%, or 80%. In the 50 children monitored only in the postoperative period, mean (SD) saturation was 97.8% +/- 1.9%. The data show that, in contrast to some reports in adults, this group of children did not have multiple episodes of clinically significant oxygen desaturation in the postoperative period.