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Local and Regional Anaesthesia

Does epidural anaesthesia decrease desaturations frequency during postoperative period?

8AP2–9

Dylczyk-Sommer, A.; Owczuk, R.; Wujtewicz, M.; Wojciechowski, J.

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European Journal of Anaesthesiology (EJA): June 12th, 2010 - Volume 27 - Issue 47 - p 132
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Background and Goal of Study: Postoperative desaturation can lead to severe hypoxaemia and even tissue hypoxia with cardiological and neurological complications. Using opioids is one of the most important risk factors of postoperative desaturation. During postoperative period oxygen therapy schould be used in order to protect against desaturation. The aim of this study was to evaluate the dsaturation frequency during the postoperative period.

Materials and Methods: 58 patients after elective open abdominal aortic aneurysm (AAA) repair, without any respiratory diseeases, ASA II-III, age 46–80, were observed in the ICU during 72 hours after the extubation. All of them had the same protocol of oxygen therapy during sponatneous breathing. Saturation was measured continously and all the incidents of desaturation (saturation below 93% for 4 mins) were noted. In the prospective, randomized study the patients were divided into two equal groups: A-after the operation epidural anesthesia was used for pain relief, B- the patients were given opioids iv for pain relief.

Results and Discussion: Desaturation was observed among 26(89%) patients in group A, and 27(93%)in group B. There was no significant differneces among the group(p=1,0).The severe hipoxaemia (saturation below 84%) was observed in group A among 7(24,13%) patients, in group B- 10(34,48%) patients. There was no significant differences among the group (p=0,3868). The median of number of desaturation incidents in group A was 10, in group B-8,9, there was no signifacant differences among the group (p=1,0). The median of desaturation time in group A was 197 min, in group B 157 min, there was no significant differences among the groups (p=0,720). Although the oxygen therapy was used incidents of desaturation was obsereved in almost 90% of patients. The patients in group B were given opioids and the frequency of desaturation and severe hypoxaemia was a little higher than in group A, but there was no significant differences among the group.

Conclusion(s): 1.Epidural anaesthesia does not protect against postoperative desaturation. 2.Oxygen therapy does not exclud postoperative desaturation and hipoxaemia.

© 2010 European Society of Anaesthesiology