Before extubation during the anesthesia recovery period, 100% oxygen is routinely inhaled to increase the oxygen reserves, maximizing the time window for anesthesiologists to adjust strategies when they encounter hypoxemia after extubation.
However, even inhaling a short period of pure oxygen can cause absorptive atelectasis, and may even impair the effectiveness of intraoperative protective ventilation measures continuing to post-operative period. The purpose of this study is to determine whether 30% oxygen before extubation after abdominal surgery could reduce hypoxemia incidence after extubation during the recovery period or not, compared to 100% oxygen. 590 patients scheduled to abdominal surgeries, will be randomly assigned to receive 30% or 100% oxygen concentration from the end of surgery to extubation after general anesthesia in the post-anesthesia care unit. The incidence of hypoxemia (SpO2 \< 90%) from extubation to leaving the post-anesthesia care unit (PACU) is the primary outcome.
Patients aged 18-65 years old, scheduled for elective abdominal surgery in general anesthesia with endotracheal intubation; ASA I-III grade; cardiac function 1-2 grade; 18 kg/m2 < BMI < 28 kg/m2; Preoperative SpO2 ≥ 94% without oxygen supplementation at rest; pre-anesthesia assessment shows no difficult airway, no difficulty with mask ventilation, no difficulty in intubation during tracheal insertion, and no difficulty in extubation as expected.
Respiratory infection recently, or atelectasis, inflammation, fibrosis, or pleural effusion by chest CT preoperatively.
Parallel
100% oxygen concentration inhaled
Other interventionOxygen concentration inhaled from the end of surgery to tracheal extubation after general anesthesia in the recovery period is 100%.
30% oxygen concentration inhaled
Other interventionOxygen concentration inhaled from the end of surgery to tracheal extubation after general anesthesia in the recovery period is 30%.
Incidence of hypoxemia
Incidence of post operative pulmonary-related complications
Incidence of severe hypoxemia
Arterial partial pressure of oxygen (PaO2)
Score of lung ultrasound
The score of lung ultrasound ranges from 0 to 36, and a higher score means a worse ventilation.
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