Risk factors of early hypoxemia in obese patients after laparoscopic sleeve gastrectomy
Objective To explore the risk factors of early postoperative hypoxemia in obese patients after laparoscopic sleeve gastrectomy(LSG).Methods A total of 271 obese patients,aged 18-50 years old,body mass index(BMI)≥35 kg/m2,men or women,at American Society of Anesthesiologists(ASA)grade Ⅰ-Ⅲ,who underwent LSG under general anesthesia from January 2017 to De-cember 2021 were selected and their clinical data were retrospectively analyzed.According to the presence of hypoxemia 30 min after entry into postanesthesia care unit(PACU),they were divided into two groups:a hypoxemia group[partial pressure of oxygen/fraction of inspiration O2(PaO2/FiO2)≤300 mmHg(1 mmHg=0.133 kPa),n=93]and a non-hypoxemia group(PaO2/FiO2＞300 mmHg,n=178).Their general information,preoperative smoking history and basic medical history,preoperative examination results,operation and anesthesia-related factors were analyzed by univariate analysis.Factors with statistical differences between the two groups were includ-ed into multivariate logistic regression analysis to evaluate the risk factors of early hypoxemia after LSG in obese patients.Results The incidence of early postoperative hypoxemia was 34.7％.Compared with the non-hypoxemia group,the hypoxemia group showed in-creases in the proportion of male patients,body weight,BMI,history of obstructive sleep apnea hypopnea syndrome(OSAHS),and the dosage of sufentanil(all P＜0.05),and extended operation time(P＜0.05),as well as decreases in preoperative forced expiratory volume in one second(FEV1)and PaO2(all P＜0.05).Multivariate logistic regression analysis showed that BMI[odds ratio(OR)1.340(95％con-fidence interval(95％CI)1.171,1.535),P＜0.001],history of OSAHS[OR 2.800(95％CI 1.423,5.511),P=0.003]and the duration of op-eration[OR 1.041(95％CI 1.017,1.066),P=0.001]were the independent risk factors for early postoperative hypoxemia in obese pa-tients after LSG.Conclusion BMI,OSAHS history and operation time are the independent risk factors for early postoperative hypox-emia in obese patients after LSG.
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