Management of early postoperative hypoxemia: a comparative performance of Hudson face mask with nasal prongs

Abstract

Introduction Early postoperative hypoxemia may occur when patients breathe room air during their initial recovery period. Prolonged hypoxemia can result in delirium, dysrhythmia, and cardiac arrest. Aim The aim of the present study was to compare the performance of face mask compared with that of the nasal prong in the management of early postoperative hypoxemia. Patients and methods All procedures were performed using standard anesthetic and surgical techniques modified to the specific procedures. All patients had peripheral oxygen saturation (SpO2) at least 97% before being transferred to the recovery room. On arrival to the recovery room, 120 patients whose SpO2 decreased up to 94% were randomly allocated to either the face mask or nasal prong groups. They were commenced on oxygen therapy at 4 l/min through either device. A modified visual analogues scale was used to evaluate the level of comfort during oxygen therapy. Results Early postoperative hypoxia occurred in 18.1%. The increase in oxygen saturation after commencement of oxygen therapy was significantly faster with nasal prongs (0.63±1.42 min) than with face mask (1.78±1.10 min) (P=0.001). The maximum SpO2 obtained was significantly higher with nasal prongs (98.77±1.29%) than with face mask (97.63±1.89%) (P<0.001). There was no significant association found between early postoperative hypoxemia and site or duration of surgery, as well as the volume of intravenous fluid (crystalloids) administered intraoperatively (P>0.05). Nasal prongs (91.7%) were significantly more comfortable compared with face mask (61.7%) (P=0.001). We have demonstrated that the use of nasal prongs was more efficient and comfortable compared with face mask in the management of early postoperative hypoxemia.