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two different time points (treated with 40% O2 oxygen therapy for 10 min and breathing room air for 10 min), duration and complication in PACU, and arterial blood gas (ABGs) data before leaving PACU. Treatment in PACU The patients in Group A receiving general anaesthesia were transferred from operating room (OR) to PACU with supplemental oxygen. Then, we treated by the general principles of guidelines for the management of tracheal extubation.21 After arrival in PACU, airway patency, vital signs, 9 oxygenation, and level of consciousness were assessed immediately and recorded every 5 min. After extubation, the patients were allowed to inhale 40% O2 at 10L min-1 by anaesthetic facial masks, 22 and then inhaled in the room air until peripheral capillary hemoglobin oxygen saturation (SpO2) remained stable. When SpO2 was less than 94%, 40% O2 was given again. If the patient had a radial artery cannulation during surgery, ABGs was routinely checked before leaving PACU. As an assessment tool, PACU nurse can determine a patient's acid-base status and initiate prompt and appropriate nursing intervention and medical consultation through ABGs23 . During the COVID-19 epidemic, the patients in Group B received general anaesthesia after elective non-cardiac surgery, with negative reverse transcription-polymerase chain reaction (RT-PCR) and chest CT scans for COVID-19 before surgery arrived the PACU in our hospital at a distance of at least 2 m (6 ft) between the two of them. 24 The anaesthesiologists and nurses wore personal protective equipment (PPE) with medical gowns, medical gloves, eye protection shields, disposable surgical caps, and surgical masks in PACU, complied with infection control measures, with alcohol-based cleaners installed at the bedside. One nurse only took care of one patient at the same time and changed medical gloves before contacting another patient. The appointment of a nurse in charge was to ensure that optimal staffing can be provided at all times, including a appropriate response to emergencies. We have tried to avoid extubation during mild anesthesia. To minimise coughing during extubation, patients received dexmedetomidine (1μg kg-1 i.v.) for over 10 min.25 The patient’s tracheal intubation and pharynx were both thoroughly aspirated before extubation. And after extubation, we placed a medical mask over the patient’s nose and mouth immediately to ensure that there was no gap between the facial mask and face, keeping a tight seal,26 then anaesthetic 10 face-mask was put above the medical mask to take in 40% O2 at 10L min-1 . We were much more careful in monitoring and oxygen therapy as wearing medical masks in PACU during the COVID-19 epidemic. After meeting all PACU discharge criteria, the patients with medical masks were transferred from PACU to their ward by nurses with a portable monitor. Other treatments accorded to patients in Group A. Primary outcome The primary outcome of the study was the oxygen saturation of patients at two different time points (treated with 40% O2 oxygen therapy for 10 min and breathing room air for 10 min) in PACU. Secondary outcome The secondary outcomes we assessed were: 1. Arterial blood gas data and patient comfort before leaving PACU. 2. HR and MBP variation after 10 min at two different time points. 3. Duration and complications after extubation in PACU. Patient comfort was evaluated by a verbal numeric rating scale (VNRS). All patients were asked to rate comfort on a 0-10-point VNRS, where, '0' was 'no comfort' and '10' was 'the most comfortable' before leaving PACU. 27 Statistical analysis Continuous variables were expressed as mean (standard deviation or inter-quartile range) for 11 normally distributed data and median (inter-quartile range) for non-normal distributions. Categorical variables were reported as the number and percentage. χ2 or Fisher’s exact test were used for categorical data, and patients’ t-test and Mann–Whitney U-test were used for continuous data in compared subjects. All statistical analyses were conducted in SPSS 21.0 statistical (SPSS, Inc. Chicago, IL, USA). P＜0.05 was considered statistically significant. Results Patients’ characteristics In this study, 151
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