Impact of Different Inspired Oxygen Concentrations during Anesthetic Emergence on Postoperative Atelectasis in Patients Undergoing Laparoscopic Radical Gastrectomy for Gastric Cancer
CAI Xin-jie
GUO Wen-ya
WANG Yang
LI Yun
Abstract：Objective To investigate the influence of different inspired oxygen concentrations during anesthetic emergence on postoperative atelectasis in elderly patients undergoing elective laparoscopic radical gastrectomy for gastric cancer.Methods Sixty-eight elderly patients scheduled for elective laparoscopic radical gastrectomy were randomly as-signed to either the high inspired oxygen concentration group(Group C)or the low inspired oxygen concentration group(Group L)with 34 patients in each group.During anesthetic emergence,Group L received 40％inspired oxygen,while Group C received 100％inspired oxygen.Bedside lung ultrasound was used to assess lung ultrasound scores(LUS)in 12 regions(6 in each lung)at entry(T0)and 30 minutes postoperatively(T4).The occurrence of postoperative atelectasis was recorded.Heart rate(HR),mean arterial pressure(MAP),and blood gas analysis including oxygen partial pressure(PaO2)and oxygenation index(OI)were documented at entry(T0),end of pneumoperitoneum(T1),extubation(T2),and PACU discharge(T3).The incidence of SpO2＜94％events in the PACU was recorded.Forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),and FEV1/FVC were measured at preoperative day 1(D0)and postop-erative days 1(D,),3(D2),and 5(D3).Clinical Pulmonary Infection Score(CPIS)on postoperative day 1 and the incidence of pulmonary complications on postoperative day 7 were recorded.Results The time from the end of pneumo-peritoneum to extubation was comparable between Group L(36.4±5.2 min)and Group C(37.3±4.2 min)(P＞0.05).Compared with Group C,Group L showed significantly lower LUS and lower incidence of postoperative atelectasis at T4(P＜0.05).At T3,Group L demonstrated significantly increased PaO2 and OI(P＜0.05).The incidence of SpO2＜94％events in the PACU was lower in Group L than in Group C(P＜0.05).Compared with D0,FE V,,FVC,and FEV1/FVC were significantly reduced in both groups on D1-3(P＜0.05).Compared with Group C,Group L showed significantly increased FEV,,FVC,and FEV1/FVC at D,(P＜0.05).There were no significant differences in CPIS on postoperative day 1 and the incidence of pulmonary complications on postoperative day 7 between the two groups(P＞0.05).Conclusion During anesthetic emergence,low inspired oxygen concentration reduces the incidence and severity of postoperative atelectasis in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer,improving early postoperative lung function.
Keywords：inhaled oxygen concentrationemergencelung ultrasoundelderlygastric cancerlung function
Publication Date：2024-02-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 194-199 )