08Dec 2018

FREQUENCY OF HYPERCAPNY WITH NORMAL PULSE OXYMETRY, DURING THE POSTANESTHETIC PERIOD, IN PATIENTS SUBJECTED TO SURGERY UNDER GENERAL ANESTHESIA.

  • Faculty of Medicine of the Autonomous University of Campeche.
  • Center for Biomedical Research. Autonomous University of Campeche.
  • Doctor Surgeon graduated from the Faculty of Medicine of the U.A.C.
  • Law graduate and researcher.
  • Faculty of Biological Chemistry.
  • Student of the Licentiate Medical Surgeon.
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  • References
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Objective: To determine the frequency of hypercapnia with normal pulse oximetry during the post-anesthetic period in patients undergoing surgery with general anesthesia. Material and methods: A longitudinal, prospective, observational and analytical study was conducted in patients under informed consent, not obstetric, undergoing general anesthesia in the HGEJBO, using non-invasive methods to measure carbon dioxide at the end of expiration (EtCO2) and determine the frequency of hypercapnia in the post-anesthetic period. Results: The study was performed with a total of 44 patients whose minimum age was 15 years, maximum of 84 and average of 43.2 ? 18 years. Of these, 36.4% (n = 16) were males and 63.6% (n = 28) females. Of the total sample, 13.6% (n = 6) presented hypercapnia in the postoperative period. No statistically significant correlations were found between the variables. Conclusions: A significant percentage of patients undergoing general anesthesia presented hypercapnia with normal pulse oximetry in the postoperative period. This scenario of perioperative risk is not specifically considered in conventional postoperative management, and there are even possibly precipitating conditions derived precisely from such management. It is suggested to seriously consider the inclusion of carbon dioxide monitoring in procedures performed under general anesthesia.

  1. Braunwald E, Fauci AS, Hauser SL, Jameson JL, Kasper D, Longo DL. Principios de medicina interna de Harrison. Decimosextaedici?n. Nueva York. McGraw-Hill; 2005.
  2. Younsuck K. Update in acute respiratory distress syndrome. J IntensiveCare. 2014;2(1): 2. DOI:10.1186/2052-0492-2-2. Disponible en https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4267604/ [Visita de sitio de internet: 10 de enero de 2017].
  3. ARDS Definition Task Force: Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307(23):2526-2533. OI:10.1001/jama.2012.5669. Disponible en http://jamanetwork.com/journals/jama/article-abstract/1160659 [Visita de sitio de internet: 10 de enero de 2017].
  4. Leaver S, Evans T. Acute respiratory failure. 2007;335(7616): 389?394. Disponible en http://oxfordindex.oup.com/view/10.1093/med/9780199204854.003.1705_update_004 [accessado 10 de enero 2017].
  5. McCarter T, Shaik Z, Scarfo K, Thompson LJ. Capnography Monitoring Enhances Safety of Postoperative Patient-Controlled Analgesia. American Health&DrugBenefits. 2008;1(5):28-35. Disponible en https://www.researchgate.net/publication/264831425_Capnography_monitoring_enhances_safety_of_postoperative_patient-controlled_analgesia [Visita de sitio de internet: 10 de enero de 2017].
  6. Krauss B, Hess D. Capnography for Procedural Sedation and Analgesia in the Emergency Department. Ann EmergMed. 2007;50(2),172-181. DOI:10.1016/j.annemergmed. 2006.10.016. Disponible en https://www.ncbi.nlm.nih.gov/labs/articles/17222941/ [Visita de sitio de internet: 10 de enero de 2017].
  7. Vadivelu N, Mitra S, Narayan D. Recent Advances in Postoperative Pain Management. The Yale Journal of Biology and Medicine. 2010;83(1):11-25. Disponible en https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844689/pdf/yjbm_83_1_11.pdf [Visita de sitio de internet: 10 de enero de 2017].
  8. Dahan A, Aarts L, Smith T. Incidence, Reversal, and Prevention of Opioid-induced Respiratory Depression. 2010;112(1):226-38. DOI: 10.1097/ALN.0b013e3181c38c25. Disponible en http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1932606 [Visita de sitio de internet: 10 de enero de 2017].
  9. Karcz M, Papadakos PJ. Respiratory complications in the postanesthesia care unit: A review of pathophysiological mechanisms. Canadian Journal of RespiratoryTherapy: CJRT. 2013;49(4):21-29. Disponible en https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4456822/ [Visita de sitio de internet: 10 de enero de 2017].
  10. Fajardo GE. Diario oficial de la federaci?n (M?xico). Norma Oficial Mexicana NOM-006-SSA3-2011, para la pr?ctica de la Anestesiolog?a. Disponible en http://dof.gob.mx/nota_detalle.php?codigo=5240668&fecha=23/03/2012 [accessado 10 de enero 2017].
  11. Committee of Origin: Standards and Practice Parameters (Approved by the ASA House of Delegates). Disponible en http://www.asahq.org/sitecore%20modules/web/~/media/modules/digital%20briefcase%20apps/asa%20practice%20management/standards%20guidelines%20statements/anesthesia%20care/standards-for-basic-anesthetic-monitoring.pdf [Visita de sitio de internet: 10 de enero 2017].
  12. Membership of the Working Party: Whitaker D, Booth H, Clyburn P, Harrop-Griffiths W, Hosie H, et al. Immediate post-anaesthesia recovery. 2013: Association of Anaesthetists of Great Britain and Ireland. Anaesthesia. 2013;68(3):288-97. DOI:10.1111/anae.12146. Disponible en http://onlinelibrary.wiley.com/. DOI:/10.1111/anae.12146/abstract [Visita de sitio de internet: 10 de enero 2017].
  13. Kodali B. Capnography outside the operating rooms. Anesthesiology. 2013;118(1):192-201. DOI: 10.1097/ALN.0b013e318278c8b6. Disponible en http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2034665 [Visita de sitio de internet: 10 de enero 2017].
  14. Laserna E, Sibila O, Aguilar P, Mortensen E, Azueto A, Blanquer J, et al. Hypocapnia and Hypercapnia Are Predictors for ICU Admission and Mortality in Hospitalized Patients With Community-Acquired Pneumonia. 2012;142(5):1193-1199. DOI:10.1378/chest.12-0576. Disponible en https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3494472/ [Visita de sitio de internet: 10 de enero 2017].
  15. Yassin Z, Saadat M, Abtahi H, RahimiForoushani A, Peiman S. Prognostic value of on admission arterial PCO2 in hospitalized patients with community-acquired pneumonia. Journal of ThoracicDisease. 2016;8(10):2765-2771. DOI:10.21037/jtd.2016.10.21. Disponible en https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107471/ [Visita de sitio de internet: 10 de enero 2017].
  16. Cook TM, Woodall N, Frerk C; Fourth National Audit Project:Major complications of airway management in the UK: Results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: Anaesthesia. Br J Anaesth. 2011;106:617?31. DOI:https://DOI.org/10.1093/bja/aer058. Disponible en https://academic.oup.com/bja/article/106/5/617/279879/Major-complications-of-airway-management-in-the-UK [Visita de sitio de internet: 10 de enero de 2017]
  17. Cook TM, Woodall N, Harper J, Benger J; Fourth NationalAudit Project: Major complications of airway management in the UK: Results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 2: Intensive care and emergency departments.Br J Anaesth. 2011;106:632?42. DOI:https://DOI.org/10.1093/bja/aer059. Disponible en? https://academic.oup.com/bja/article/106/5/632/279958/Major-complications-of-airway-management-in-the-UK?sid=4c3b4ca4-c779-40df-9aa0-d130b2cf350d [Visita de sitio de internet: 10 de enero de 2017]
  18. Ayas N, Bergstrom L, Schwab T, Narr B. Unrecognized severe postoperative hypercapnia: a case of apneic oxygenation. Mayo Clin Proc. 1998;73(1):51-4. DOI: http://dx.DOI.org/10.1016/S0025-6196(11)63619-7. Disponible en http://www.mayoclinicproceedings.org/article/S0025-6196(11)63619-7/fulltext [Visita de sitio de internet: 10 de enero 2017].

[Betty Sarabia Alcocer, Luis Alberto Nunez Oreza, Betty Monica Velazquez Sarabia, Priscilla Karmina Velazquez Sarabia, Paulino Tamay Segovia, Selene Blum Dominguez, Patricia Margarita Garma Quen, Rafael Manuel de Jesus Mex Alvarez, and Angel Arturo Ake Ordonez. (2018); FREQUENCY OF HYPERCAPNY WITH NORMAL PULSE OXYMETRY, DURING THE POSTANESTHETIC PERIOD, IN PATIENTS SUBJECTED TO SURGERY UNDER GENERAL ANESTHESIA. Int. J. of Adv. Res. 6 (Dec). 507-513] (ISSN 2320-5407). www.journalijar.com

Betty Sarabia Alcocer
Universidad Autónoma de Campeche

DOI:

Article DOI: 10.21474/IJAR01/8166      
DOI URL: https://dx.doi.org/10.21474/IJAR01/8166

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