Supplemental oxygen administration practices in post anesthesia care unit of a tertiary care hospital: an observational prospective study

Abstract

Introduction: Oxygen supplementation in post anesthesia care unit (PACU) is a safe, simple and effective method to ensure adequate oxygenation in most patients recovering from anesthesia. Despite dearth of clinical studies demonstrating the need for routine oxygen therapy in every postoperative patient, routine administration of oxygen is common in the PACU irrespective of the type of surgery, physical status of patient or technique of anesthesia employed, thus wasting important resource. The study was conducted to observe supplemental oxygen administration practices to adult patients in PACU of a tertiary care teaching hospital.
Methodology: This was a prospective observational study with inclusion of all adult American Society of Anesthesiologists (ASA) physical status I, II, and III patients undergoing general anesthesia and central neuraxial blocks being shifted to PACU. Institutional ethical review committee approval was taken. A trained research assistant collected data with defined variables in PACU of a tertiary care hospital in a specially designed form.
Results: A total of five hundred and eighty five adult patients were enrolled in this study. Four thirty one (74%) patients received supplemental oxygen in PACU.  Among 431 patients who received supplemental oxygen in recovery room, 373 (86%) patients received oxygen therapy without any specific reason. In fourteen patients (2.4%), transient hypoxemia was observed, increasing oxygen flow and addressing the underlying cause managed that.
Conclusion: Supplemental oxygen practice was not standardized in the PACU. Majority of the patients received oxygen supplementation without any specific clinical indication. Hypoxic event in PACU is not common and can easily be managed with vigilant monitoring and timely intervention.