Abstract

RINCON-VALENZUELA, David A  and  BENAVIDES CAROH, Alexandra. Use of intra-operative supplemental oxygen to reduce morbidity and mortality in general anesthesia: systematic review and meta-analysis of randomized controlled trials. Rev. colomb. anestesiol. [online]. 2012, vol.40, n.1, pp.34-51. ISSN 0120-3347.  https://doi.org/10.1016/S0120-3347(12)70009-6.

Objective: To evaluate the effectiveness and safety of oxygen supplementation (inspired fraction of oxygen, FiO₂) in high concentrations versus low concentrations, given with the aim of reducing complications in patients undergoing surgical procedures under general anesthesia. Methods: A systematic review and a meta-analysis were performed following the methodology proposed by the Cochrane Collaboration. The review included controlled clinical trials conducted in patients undergoing surgical procedures under general anesthesia. After conducting data base searches (PUBMED, CENTRAL y LILACS), and once the relevant studies were identified, additional snowballing ambispective and grey literature searches were done. Results: Of the 17 clinical trials finally included (4844 patients), 7 were considered to a have a low risk of bias. High FiO₂ levels reduce post-operative nausea and vomiting only in surgeries with extensive intestinal manipulation (odds ratio [OR] 0.40; 95% confidence interval [CI] , 0.20 to 0.80). In this same clinical setting, the risk of surgical site infection (OR 0.46; 95% CI, 0.29 to 0.74), and mortality (OR 0.17; 95% CI, 0.03 to 0.99) are also reduced. There was no impact on the need for rescue anti-emetic administration, length of stay in the post-anesthetic care unit, unexpected admission to the intensive care unit, or post-operative hospital stay in any of the surgical populations. Conclusions: Intra-operative oxygen supplementation in high concentrations (> 60%) might reduce the risk of surgical site infection and mortality in surgeries with extensive intestinal manipulation.

Keywords : General anesthesia; Effectiveness; Safety; Morbidity.

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